Victory Clinical Services Ii Llc

LBN: Victory Clinical Services Ii Llc
Victory Clinical Services Ii Llc is an health care organization with primary practice located at 4218 W Western Ave , South Bend IN 46619-2622. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Health Service, Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. Victory Clinical Services Ii Llc can be contacted via phone (574) 233-1524, or through Blankenship, David via phone (574) 233-1524.

Contact Information

Primary practice address
4218 W Western Ave South Bend IN 46619-2622
Phone: (574) 233-1524
Fax: (574) 233-1612
Website:
Map and Directions
Authorized official contact:
Name: Blankenship, David
Phone: (574) 233-1524

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20010221A Indiana
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 02001493A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001833A Indiana

Profile Details

NPI number 1497798284
LBN Legal business name Victory Clinical Services Ii Llc
DBA Doing business as
Authorized official Blankenship, David
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2006
Last updated Mar 22nd, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497798284 NPPES
Indiana Other 1255432233 WOODWARD NPC - NPI
Indiana MEDICAID 168750 WOODWARD NPC - NPI
Indiana MEDICAID 100220790 WOODWARD NPC - NPI
Indiana MEDICAID 200495610 WOODWARD NPC - NPI
Indiana Other 1518055565 WOODWARD NPC - NPI
Indiana Other 1982647434 WOODWARD NPC - NPI

Popular Providers