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VICTORIOUS HEALTHCARE L.L.C.

Nursing & Custodial Care Facilities Assisted Living Facility

Provider NPI: 1912455361

Organization Information:
Organization Name:  VICTORIOUS HEALTHCARE L.L.C.
Organization is not Subpart
Authorized Official:  MARY JEAN BEN  C.E. O.  601-209-4278

Practice Location:
4959 LAUREL OAK DR  JACKSON, MS 39212-2150 US
Tel: 601-209-4278  Fax: --

Business Mailing Address:
4959 LAUREL OAK DR  JACKSON, MS 39212-2150 US
Tel: 601-209-4278  Fax: --

NPI Information:
NPI: 1912455361
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N310400000XNursing & Custodial Care Facilities
Assisted Living Facility
N313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
N314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
N315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
N320600000XResidential Treatment Facilities
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
N324500000XResidential Treatment Facilities
Substance Abuse Rehabilitation Facility
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N332BN1400XSuppliers
Durable Medical Equipment & Medical Supplies
N332BX2000XSuppliers
Durable Medical Equipment & Medical Supplies
N332U00000XSuppliers
Home Delivered Meals
N343800000XTransportation Services
Secured Medical Transport (VAN)
N347C00000XTransportation Services
Private Vehicle
N385H00000XRespite Care Facility
Respite Care
N385HR2060XRespite Care Facility
Respite Care
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 311ZA0620X

Type:

Classification:



Definition:



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