Provider Type Icon

VICTORY RECOVERY LLC NPI 1700517265


NPI Information

NPI: 1700517265
Provider Name: VICTORY RECOVERY LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2281542

Address:
1045 E UNIVERSITY DR STE B
MESA, AZ
ZIP 85203
Phone: (480) 416-4813
Get Directions

VICTORY RECOVERY LLC is a community behavioral health in Mesa, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. VICTORY RECOVERY LLC NPI is 1700517265. The provider is registered as an organization entity type.

The provider's business location address is:

1045 E UNIVERSITY DR STE B
MESA, AZ
ZIP 85203-000
Phone: (480) 416-4813

The provider's authorized official is Max Hall .
The authorized official title is Co-owner and has the following contact phone number (480) 416-4813.

The CLIA number assigned to this NPI record is 03D2281542 - other - addiction outpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2022 and was last updated on 6/23/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)No
3251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.