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General NPI Number Information
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NPI Number | 1861336794
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Entity Type | Individual
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Provider Name | VICTORIA COOK
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Gender | Female
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 1805 N 73RD ST
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City | OMAHA
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State | NE
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Zip | 68114-1905
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Country | US
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Telephone | 402-557-8583
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Fax |
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Provider Business Mailing Address
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Address Line | 413 N WEST ST
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City | MISSOURI VALLEY
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State | IA
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Zip | 51555-1453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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