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NPI Code Detail

MEDICARE: VICTORY HOME HEALTH CARE, INC.

MEDICARE: VICTORY HOME HEALTH CARE, INC.
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
1251E00000XHome Health Agency550001045CA

General Provider Information

NPI Number : 1194904300
Entity Type Code : Organization
Provider Name (Legal Business Name) : VICTORY HOME HEALTH CARE, INC.
Provider Business Mailing Address
First Line : 1604 VICTORY BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91201-2915
Country : US
Telephone Number : 818-247-2099
Fax Number : 818-247-2094
Provider Business Practice Location Address
First Line : 1604 VICTORY BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91201-2915
Country : US
Telephone Number : 818-247-2099
Fax Number : 818-247-2094
Authorized Official
Title or Position : CEO
Name : ELIZAVETA ANTONIAN
Credential :
Telephone Number : 818-247-2099
Provider Enumeration Date : 10/24/2007
Last Update Date : 01/04/2011

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Directions to “VICTORY HOME HEALTH CARE, INC. ” Practice Location

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