Provider Demographics
NPI:1164039814
Name:VICTORIOUS CLEANING LLC
Entity Type:Organization
Organization Name:VICTORIOUS CLEANING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-534-8942
Mailing Address - Street 1:19399 COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:PLATTEVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80651-8916
Mailing Address - Country:US
Mailing Address - Phone:970-534-8942
Mailing Address - Fax:
Practice Address - Street 1:19399 COUNTY ROAD 25
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:CO
Practice Address - Zip Code:80651-8916
Practice Address - Country:US
Practice Address - Phone:970-534-8942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-27
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty