Provider Demographics
NPI:1689222028
Name:VICTORY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:VICTORY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:202-316-3391
Mailing Address - Street 1:6704 TERRA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3748
Mailing Address - Country:US
Mailing Address - Phone:202-316-3391
Mailing Address - Fax:
Practice Address - Street 1:6704 TERRA ALTA DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3748
Practice Address - Country:US
Practice Address - Phone:240-716-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VICTORY ASSISTED LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care