VICTORY VILLAGE (NPI# 1912409137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912409137 |
| Entity Type | Organization |
| Organization Name | VICTORY VILLAGE |
| Practice Address |
3650 Salem Church Rd Jasper GA 30143-5288 |
| Practice Telephone | 7707352219 |
| Practice Fax Number | 7708280698 |
| Mailing Telephone | 7707352219 |
| Mailing Fax Number | 7708280698 |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-03 |
| Authorized Official Name | MS. TAMMY LYNN CRIDER (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 7707352219 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | PCH008447 | GA | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VICTORY VILLAGE AMADOR | 12408 Kennedy Flat, Jackson, CA 95642-9576 |
| System for Award Management (SAM) Entities | VICTORY VILLAGE LA LLC | 157 E New England Ave Ste 240, Winter Park, FL 32789-7006 |
| Colorado Business Entities | VICTORY VILLAGE LLC | 6261 Monaco St, Commerce City, CO 80022 |
| Washington State Corporations | VICTORY VILLAGE LLC | 1013 Ne 14th Ave, Battle Ground, WA 98604-4784 |
| Virginia Business Entities | Victory Village Property Owners Association Inc. | 200 High Street, Suite 409, Portsmouth, Virginia 23704 |
| Street Address |
3650 SALEM CHURCH RD |
| City | JASPER |
| State | GA |
| Zip Code | 30143-5288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
| 1598363434 | Amanda J Griggs | Massage Therapist | 54 Wolfscratch Village, Jasper, GA 30143 | 2020-10-13 |
| 1801397724 | Jema Day | Nurse Practitioner | 620 J L White Dr Ste 140, Jasper, GA 30143 | 2018-02-26 |
| 1023467545 | North Georgia Personal Care LLC | Home Health | 501 North Main St., Suite B, Jasper, GA 30143 | 2016-06-06 |
| 1871979641 | Sj & J Spine and Pain Group Holding LLC | Pain Medicine | 91 Sammy Mcghee Blvd, Suite 101, Jasper, GA 30143 | 2015-08-04 |
| 1801294293 | Highland Recovery Center | Community/Behavioral Health | 323 Roland Road, Jasper, GA 30143 | 2014-12-17 |
| 1770905861 | Leslie Rhea Hanagan | Speech-Language Pathologist | 22 Dogwood Lane, Jaser, GA 30143 | 2014-01-09 |
| 1669800660 | Pickens County Chiropractic | Chiropractor | 95 North Main Street, Jasper, GA 30143 | 2013-10-29 |
| 1407139264 | Rocky Mountain Holdings LLC | Ambulance | 70 Airport Business Court, Jasper, GA 30143 | 2011-09-27 |
| 1851681415 | Richard J Vandam | Internal Medicine | 1266 Highway 515, Piedmont Mountainside Hospital, Jasper, GA 30143 | 2011-04-15 |
| Find all providers in zip 30143 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235622820 | Sunrise Village Care LLC | Assisted Living Facility | 573 Pioneer Rd, Jasper, GA 30143-1225 | 2018-06-08 |
| 1942643135 | Jasper Sunrise Village | Assisted Living Facility | 100 Robert Ave N, Jasper, MN 56144-1219 | 2013-04-08 |
| 1417139221 | Rosewood Assisted Living Center, Inc | Assisted Living Facility | 41 Chestnut Cir, Jasper, TX 75951-4817 | 2007-12-04 |
| 1164758330 | Greene County General Hospital | Assisted Living Facility | 2515 Newton St, Jasper, IN 47547-1047 | 2009-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475086 | The We Care Homecare Foundation, Inc | Assisted Living Facility | 5701 Mableton Pkwy Sw Ste 306, Mableton, GA 30126-3360 | 2020-10-18 |
| 1871100412 | Forever Harmony PCh Inc | Assisted Living Facility | 205 Providence Walk Ct, Canton, GA 30114-8622 | 2020-09-28 |
| 1063026953 | New Hope Living Centre Dba The Fite Living Centre | Assisted Living Facility | 5 Fite St, Cartersville, GA 30120-3408 | 2020-09-08 |
| 1033723697 | Jordan Scott Seamans | Assisted Living Facility | 7778 Schomburg Rd Apt 610, Columbus, GA 31909-1928 | 2020-09-01 |
| 1225641368 | Renaissance Gainesville 1, LLC | Assisted Living Facility | 2215 Old Hamilton Pl, Gainesville, GA 30507-7893 | 2020-08-28 |
| 1770193120 | Simply Living Personal Care Home, LLC | Assisted Living Facility | 3 Berwick Ct, Savannah, GA 31406-6721 | 2020-07-31 |
| 1487276184 | 1115 Smith Opco LLC | Assisted Living Facility | 135 Market St, Thomasville, GA 31792-5782 | 2020-05-15 |
| 1497376545 | Shawitekia Johnson | Assisted Living Facility | 312 Magnolia Dr, Thomson, GA 30824-1842 | 2020-04-29 |
| 1366075848 | Liagiba, Inc | Assisted Living Facility | 518 Lake Michele Ct, Stone Mountain, GA 30088-1401 | 2020-02-13 |
| 1639701352 | Angels Live Here Inc. | Assisted Living Facility | 89 Level Creek Rd, Suwanee, GA 30024-1779 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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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.