MEDICARE: VICTORY HOME CARE 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	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1841134988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY HOME CARE LLC

Provider Business Mailing Address
First Line	:	4739 JOPLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-5535
Country	:	US
Telephone Number	:	720-394-6998
Fax Number	:	720-394-6998

Provider Business Practice Location Address
First Line	:	4739 JOPLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-5535
Country	:	US
Telephone Number	:	720-394-6998
Fax Number	:	720-394-6998

Authorized Official
Title or Position	:	CEO
Name	:	VICTORIA NNEOMA EMMANUEL
Credential	:	EMMANUEL
Telephone Number	:	720-394-6998

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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