VICTORY HEALTH CARE SERVICES LLC (NPI# 1063910859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063910859 |
| Entity Type | Organization |
| Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Other Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Practice Address |
499c Beaumont Avenue Suite 18 Baltimore MD 21212 |
| Mailing Address |
5808 York Rd Fl 2 Baltimore MD 21212-3624 |
| Practice Telephone | 4432045144 |
| Practice Fax Number | 6672122430 |
| Mailing Telephone | 4432045144 |
| Mailing Fax Number | 4106178478 |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2019-07-19 |
| Authorized Official Name | BODE AKADRI (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 4432045144 |
| Authorized Official Credential | BED, MMP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1972978716 | 05 |
| Other Name | Type Code |
|---|---|
| Victory Health Care Services | Doing Business As Name - Organization |
| VICTORY HEALTH CARE SERVICES LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205485588 | Victory Health Care Services LLC | Counselor | 5209 York Rd Ste 2, Baltimore, MD 21212-4225 | 2019-09-09 |
| 1972978716 | Victory Health Care Services LLC | Community/Behavioral Health | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2015-12-04 |
| 1861005035 | Victory Health Care Services LLC | Clinic/Center | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2020-08-28 |
| 1578176731 | Victory Health Care Services LLC | Community/Behavioral Health | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2020-08-27 |
| 1699393744 | Victory Health Care Services LLC | Clinical Nurse Specialist | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2020-07-06 |
| 1083252696 | Victory Health Care Services LLC | Counselor | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2019-12-13 |
| Street Address |
499C BEAUMONT AVENUE SUITE 18 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750935227 | Leigh Anne Tabernero | Counselor | 6600 York Rd Suite 110, Towson, MD 21212 | 2019-08-01 |
| 1245734250 | Jeri Michele Mankye | Counselor | 814 Radnor Ave, Baltimore, MD 21212 | 2018-03-23 |
| 1063927622 | Janice Furst | Psychologist | 421 Old Trail, Baltimore, MD 21212 | 2017-12-05 |
| 1689196537 | Huber Rehabilitation Services | Counselor | 500 Woodbourne, Baltimore, MD 21212 | 2017-07-12 |
| 1639608037 | Christina Joy Antolick | Behavior Technician | 1007 Lenton Ave, Baltimore, MD 21212 | 2017-06-08 |
| 1902359979 | Miriam Trader | Speech-Language Pathologist | 500 Overbrook Road, Baltimore, MD 21212 | 2016-07-26 |
| 1497137269 | Candy Carter | Social Worker | 5900 York Rd Ste 108, Baltimore, MD 21212 | 2015-06-29 |
| 1053703298 | Cathryne L. Maciolek, Psy.d., LLC | Psychologist | 540 E. Belvedere Avenue, Suite 203, Baltimore, MD 21212 | 2015-02-25 |
| 1891034831 | Ashley Martin | Social Worker | 6401 York Road Third Floor, Towson, MD 21212 | 2013-02-12 |
| 1508149881 | Kelly M Brenan Rothschild | Pathology | 708 Regester Ave, Baltimore, MD 21212 | 2011-09-23 |
| Find all providers in zip 21212 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
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| 1295214617 | Compassionate Health Services LLC | Clinic/Center | 9403 Harford Rd Ste 6, Baltimore, MD 21234-3123 | 2018-08-07 |
| 1275022170 | Second Chance Behavioral Health Center LLC | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-07 |
| 1174077796 | Mosaic Community Services, Inc. | Clinic/Center | 9201 Philadelphia Rd, Baltimore, MD 21237-4318 | 2016-08-11 |
| 1427502046 | Mosaic Community Services, Inc. | Clinic/Center | 9201 Philadelphia Rd, Baltimore, MD 21237-4318 | 2016-08-11 |
| 1588016422 | Mosaic Community Services, Inc. | Clinic/Center | 234 S Broadway, Baltimore, MD 21231-2405 | 2016-07-03 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.