VICTORY HEALTH CARE SERVICES LLC (NPI# 1205485588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205485588 |
| Entity Type | Organization |
| Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Practice Address |
5209 York Rd Ste 2 Baltimore MD 21212-4225 |
| Practice Telephone | 4432045144 |
| Practice Fax Number | 4106178478 |
| Mailing Telephone | 4432045144 |
| Mailing Fax Number | 4106178478 |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | MR. BODE AKADRI (DIRECTOR) |
| Authorized Official Telephone | 4432045144 |
| Authorized Official Credential | MPP |
| Is Organization Subpart | Y |
| Parent Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| victory health care services llc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063910859 | Victory Health Care Services LLC | Clinic/Center | 499c Beaumont Avenue, Suite 18, Baltimore, MD 21212 | 2018-01-26 |
| 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 |
5209 YORK RD STE 2 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21212-4225 |
| 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 |
| 1063910859 | Victory Health Care Services LLC | Clinic/Center | 499c Beaumont Avenue, Suite 18, Baltimore, MD 21212 | 2018-01-26 |
| 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 |
| Find all providers in zip 21212 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091522 | Choices Integrated Healthcare | Counselor | 1600 Bush St, Baltimore, MD 21230-2021 | 2020-10-22 |
| 1730791609 | Tony C Shaw | Counselor | 2814 W Garrison Ave, Baltimore, MD 21215-5335 | 2020-08-20 |
| 1023628849 | Delores Jordan | Counselor | 2640 Oswego Ave, Baltimore, MD 21215-7037 | 2020-08-06 |
| 1144838277 | Guiding Lives | Counselor | 6305 Belair Rd, Baltimore, MD 21206-1817 | 2020-07-15 |
| 1750908943 | New Life Services LLC. | Counselor | 3600 W Mulberry St, Baltimore, MD 21229-2928 | 2020-07-03 |
| 1801413422 | Karena Tinika Lee | Counselor | 1336 Homestead St, Baltimore, MD 21218-3624 | 2020-06-30 |
| 1578189668 | Chenelle Gould | Counselor | 4018 Elmora Ave, Baltimore, MD 21213-2120 | 2020-06-24 |
| 1811513625 | Ebony Michelle Johnson | Counselor | 2808 Carver Rd, Baltimore, MD 21225-1312 | 2020-06-18 |
| 1992321798 | Robert Murray | Counselor | 1703 Windemere Ave, Baltimore, MD 21218-3029 | 2020-06-18 |
| 1629694591 | Natale Fiumara | Counselor | 821 N Eutaw St Ste 201, Baltimore, MD 21201-6301 | 2020-06-17 |
| 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.