VICTORIOUS HEALTHCARE L.L.C. NPI 1912455361

NPI Information

NPI: 1912455361
Provider Name: VICTORIOUS HEALTHCARE L.L.C.
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
4959 LAUREL OAK DR
JACKSON, MS
ZIP 39212
Phone: (601) 209-4278
Get Directions

VICTORIOUS HEALTHCARE L.L.C. is an adult care home custodial care facility in Jackson, MS. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. VICTORIOUS HEALTHCARE L.L.C. NPI is 1912455361. The provider is registered as an organization entity type.

The provider's business location address is:

4959 LAUREL OAK DR
JACKSON, MS
ZIP 39212-150
Phone: (601) 209-4278

The provider's authorized official is Mary Jean Ben .
The authorized official title is C.e. O. and has the following contact phone number (601) 209-4278.

The enumeration date for this NPI number is 9/14/2016 and was last updated on 9/14/2016.

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	Primary
1	310400000X	Assisted Living Facility		No
2	313M00000X	Nursing Facility/Intermediate Care Facility		No
3	314000000X	Skilled Nursing Facility		No
4	315P00000X	Intermediate Care Facility, Intellectual Disabilities		No
5	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		No
6	324500000X	Substance Abuse Rehabilitation Facility		No
7	332B00000X	Durable Medical Equipment & Medical Supplies		No
8	332BN1400X	Durable Medical Equipment & Medical Supplies	Nursing Facility Supplies	No
9	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies	No
10	332U00000X	Home Delivered Meals		No
11	343800000X	Secured Medical Transport (VAN)		No
12	347C00000X	Private Vehicle		No
13	385H00000X	Respite Care		No
14	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities	No
15	311ZA0620X	Custodial Care Facility	Adult Care Home	Yes

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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