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General NPI Number Information
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NPI Number | 1952930414
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Entity Type | Organization
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Legal Business Name | VICTORY CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 05/01/2020
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Provider Practice Location Address
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Address Line | 24 OPERA HOUSE SQ STE 210
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City | CLAREMONT
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State | NH
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Zip | 03743-5408
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Country | US
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Telephone | 603-632-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 32 NEW ALDRICH RD
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City | GRANTHAM
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State | NH
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Zip | 03753-3146
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Country | US
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Telephone | 240-444-0049
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Fax |
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Authorized Official
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Title or Position | OWNER AND EXECUTIVE DIRECTOR
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Name | MR. JOSEPH COOPER
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Credential |
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Telephone | 240-444-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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