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General NPI Number Information
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NPI Number | 1326732967
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Entity Type | Organization
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Legal Business Name | VICTORIOUS ASSISTED LIVING PROPERTIES, LLC
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 3815 FM 646 RD N
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City | SANTA FE
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State | TX
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Zip | 77510-6104
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Country | US
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Telephone | 281-456-2074
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Fax | 888-345-0549
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Provider Business Mailing Address
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Address Line | PO BOX 2732
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City | LEAGUE CITY
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State | TX
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Zip | 77574-2732
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Country | US
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Telephone | 281-456-2074
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Fax | 883-450-5498
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Authorized Official
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Title or Position | MANAGER
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Name | DEXTER L GUICE
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Credential |
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Telephone | 713-256-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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