MEDICARE: VICTORY IS OURZ COMPANION & HOMEMAKER AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1144176298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY IS OURZ COMPANION & HOMEMAKER AGENCY LLC

Provider Business Mailing Address
First Line	:	2555 KING LOUIS DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-6220
Country	:	US
Telephone Number	:	904-257-6224
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 KING LOUIS DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-6220
Country	:	US
Telephone Number	:	904-257-6224
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MYKHIA HELENA SMITH
Credential	:
Telephone Number	:	904-257-6224

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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