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NPI Code Detail

MEDICARE: VICTORY HOME HEALTH CARE

MEDICARE: VICTORY HOME HEALTH CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility122220TX
2323P00000XPsychiatric Residential Treatment Facility122220TX

General Provider Information

NPI Number : 1538310321
Entity Type Code : Organization
Provider Name (Legal Business Name) : VICTORY HOME HEALTH CARE
Provider Business Mailing Address
First Line : 5326 CHESNUT VIEW DR
Second Line :
City : SAN
State : TX
Zip : 78247-5000
Country : US
Telephone Number : 210-797-9544
Fax Number : 210-848-3048
Provider Business Practice Location Address
First Line : 5326 CHESNUT VIEW DR
Second Line :
City : SAN
State : TX
Zip : 78247-5000
Country : US
Telephone Number : 210-797-9544
Fax Number : 210-848-3048
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. LUCIA CAROLINA MONTEZ
Credential :
Telephone Number : 210-797-9544
Provider Enumeration Date : 10/10/2008
Last Update Date : 10/10/2008

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Directions to “VICTORY HOME HEALTH CARE ” Practice Location

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