MEDICARE: VICTORY CARE

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	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376072173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY CARE

Provider Business Mailing Address
First Line	:	5455 WILSHIRE BLVD STE 800
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4271
Country	:	US
Telephone Number	:	917-613-2142
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 WILSHIRE BLVD STE 800
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-4271
Country	:	US
Telephone Number	:	917-613-2142
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	ELI SCHARF
Credential	:
Telephone Number	:	917-613-2142

Provider Enumeration Date	:	06/06/2017
Last Update Date	:	06/24/2022

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Directions to “VICTORY CARE ” Practice Location

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