Healthcare Provider Details

I. General information

NPI: 1033013586
Provider Name (Legal Business Name): VICTORY BEHAVIOR & SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 CLINTON AVE
NEW HAVEN CT
06513-3101
US

IV. Provider business mailing address

46 CLINTON AVE
NEW HAVEN CT
06513-3101
US

V. Phone/Fax

Practice location:
  • Phone: 475-326-2153
  • Fax: 860-269-9348
Mailing address:
  • Phone: 475-326-2153
  • Fax: 860-269-9348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEVAHN ISSIAH MURPHY
Title or Position: OWNER
Credential: BA
Phone: 386-216-5812