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General NPI Number Information
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NPI Number | 1700073194
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Entity Type | Organization
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Legal Business Name | VICTORY REHABILITATION AND HEALTHCARE CENTER, LLC
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 510 N PARKWAY AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8004
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Country | US
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Telephone | 360-687-5141
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Fax | 360-687-1897
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Provider Business Mailing Address
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Address Line | 510 N PARKWAY AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8004
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Country | US
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Telephone | 360-687-5141
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Fax | 360-687-1897
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRAIG E ROBINSON
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Credential |
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Telephone | 901-937-7994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1406
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License Number State | WA
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