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General NPI Number Information
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NPI Number | 1649919465
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Entity Type | Organization
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Legal Business Name | VICTORIOUS HOME NURSING, INC
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 414 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-1739
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Country | US
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Telephone | 815-464-9201
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Fax | 815-464-9202
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Provider Business Mailing Address
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Address Line | 414 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-1739
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Country | US
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Telephone | 815-464-9201
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Fax | 815-646-9202
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VIRGINIA C EBIRINGAH
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Credential | RN
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Telephone | 815-464-9201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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