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General NPI Number Information
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NPI Number | 1538310321
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Entity Type | Organization
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Legal Business Name | VICTORY HOME HEALTH CARE
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 10/10/2008
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Provider Practice Location Address
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Address Line | 5326 CHESNUT VIEW DR
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City | SAN
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State | TX
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Zip | 78247-5000
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Country | US
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Telephone | 210-797-9544
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Fax | 210-848-3048
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Provider Business Mailing Address
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Address Line | 5326 CHESNUT VIEW DR
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City | SAN
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State | TX
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Zip | 78247-5000
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Country | US
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Telephone | 210-797-9544
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Fax | 210-848-3048
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LUCIA CAROLINA MONTEZ
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Credential |
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Telephone | 210-797-9544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 122220
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 122220
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License Number State | TX
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