VICTORY CLINICAL SERVICES LANSING NPI 1861627507

NPI Information

  • NPI: 1861627507
  • Provider Name: VICTORY CLINICAL SERVICES LANSING
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • Address: 4902 S CEDAR ST
    LANSING, MI
    ZIP 48910
  • Phone: (517) 394-7867

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NPI Details

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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm (HCPCS:G2067)
  • Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure (HCPCS:G2078)
  • Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for (HCPCS:G2077)

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
1261QM0850XClinic/CenterAdult Mental Health330330MICHIGANNo
2261QM2800XClinic/CenterMethadone330330MICHIGANYes

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
1MI 10046MOTHERMICHIGANOTP - 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: 3/30/2025

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