VICTORY HEALTH CARE SERVICES LLC (NPI# 1699393744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699393744 |
| Entity Type | Organization |
| Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Practice Address |
5808 York Rd Fl 2 Baltimore MD 21212-3624 |
| Practice Telephone | 4432045144 |
| Practice Fax Number | 4106178478 |
| Mailing Telephone | 4432045144 |
| Mailing Fax Number | 4106178478 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | MR. BODE AKADRI (CEO) |
| Authorized Official Telephone | 4432045144 |
| Is Organization Subpart | Y |
| Parent Organization Name | VICTORY HEALTH CARE SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0812X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Community |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| VICTORY HEALTH CARE SERVICES LLC | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5808 York Rd Fl 2, Baltimore, MD 212123624 | 4432045144 | 4106178478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205485588 | Victory Health Care Services LLC | Counselor | 5209 York Rd Ste 2, Baltimore, MD 21212-4225 | 2019-09-09 |
| 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 |
| 1083252696 | Victory Health Care Services LLC | Counselor | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2019-12-13 |
| Street Address |
5808 YORK RD FL 2 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21212-3624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1083252696 | Victory Health Care Services LLC | Counselor | 5808 York Rd Fl 2, Baltimore, MD 21212-3624 | 2019-12-13 |
| 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 | 364SP0812X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Community |
| Definition to come... |
Please comment or provide details below to improve the information on VICTORY HEALTH CARE SERVICES LLC.
| 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.