Provider Demographics
NPI:1851642110
Name:VICTORY SENIOR CARE, INC.
Entity Type:Organization
Organization Name:VICTORY SENIOR CARE, INC.
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANESZKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-352-7272
Mailing Address - Street 1:2225 LAWRENCEBURG RD
Mailing Address - Street 2:BUILDING A SUITE 4
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-9128
Mailing Address - Country:US
Mailing Address - Phone:502-352-7272
Mailing Address - Fax:502-352-7273
Practice Address - Street 1:2225 LAWRENCEBURG RD
Practice Address - Street 2:BUILDING A SUITE 4
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-9128
Practice Address - Country:US
Practice Address - Phone:502-352-7272
Practice Address - Fax:502-352-7273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500030253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care