VICTORY CLINICAL SERVICES LANSING NPI 1861627507

NPI Information

NPI: 1861627507
Provider Name: VICTORY CLINICAL SERVICES LANSING
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
4902 S CEDAR ST
LANSING, MI
ZIP 48910
Phone: (517) 394-7867
Get Directions

VICTORY CLINICAL SERVICES LANSING is a methadone clinic center in Lansing, MI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. VICTORY CLINICAL SERVICES LANSING NPI is 1861627507. The provider is registered as an organization entity type.

The provider's business location address is:

4902 S CEDAR ST
LANSING, MI
ZIP 48910-474
Phone: (517) 394-7867
Fax: (517) 394-7869

The provider's authorized official is David Blankenship .
The authorized official title is Program Director and has the following contact phone number (517) 394-7867.

The enumeration date for this NPI number is 5/26/2009 and was last updated on 3/22/2012.

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
1	261QM0850X	Clinic/Center	Adult Mental Health	330330	MICHIGAN	No
2	261QM2800X	Clinic/Center	Methadone	330330	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MI 10046M	OTHER	MICHIGAN	OTP - SAMHSA #

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: 4/28/2024

NPI Synchronization or Removal

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