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General NPI Number Information
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NPI Number | 1528975208
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Entity Type | Organization
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Legal Business Name | VICTORY HOMES LLC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 201 BROWN ST
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City | PADUCAH
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State | KY
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Zip | 42003-2050
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Country | US
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Telephone | 270-252-6884
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Fax | 270-477-5693
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Provider Business Mailing Address
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Address Line | 201 BROWN ST
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City | PADUCAH
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State | KY
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Zip | 42003-2050
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Country | US
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Telephone | 270-252-6884
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Fax | 270-477-5693
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH TYRIE
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Credential |
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Telephone | 270-252-6884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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