Provider Demographics
NPI:1053065193
Name:VICTORY HELPING HANDS LLC
Entity Type:Organization
Organization Name:VICTORY HELPING HANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WONLUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-996-1016
Mailing Address - Street 1:16805 WINSTON LN
Mailing Address - Street 2:MAILING ADDRESS
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:401-996-1016
Mailing Address - Fax:
Practice Address - Street 1:16805 WINSTON LN
Practice Address - Street 2:MAILING ADDRESS
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:401-996-1016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VICTORY HELPING HANDS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3246Medicaid