Provider Demographics
NPI:1366864365
Name:VICTORY CARE LLC
Entity Type:Organization
Organization Name:VICTORY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-703-6791
Mailing Address - Street 1:713 GATEWOOD RD
Mailing Address - Street 2:D
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:214-703-6791
Mailing Address - Fax:214-703-6799
Practice Address - Street 1:713 GATEWOOD RD
Practice Address - Street 2:D
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:214-703-6791
Practice Address - Fax:214-703-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care