Healthcare Provider Details

I. General information

NPI: 1134001910
Provider Name (Legal Business Name): VICTORIOUS PRESTIGE WELLNESS AND ADVOCACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 BOCA LAGO DR
VALPARAISO IN
46383-3905
US

IV. Provider business mailing address

1707 BOCA LAGO DR
VALPARAISO IN
46383-3905
US

V. Phone/Fax

Practice location:
  • Phone: 219-617-4651
  • Fax:
Mailing address:
  • Phone: 219-617-4651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. VICTORIA MARIE SCHWARTEN
Title or Position: OWNER
Credential: MSN, APRN, FNP-C
Phone: 219-617-4651