Provider Demographics
NPI:1184946113
Name:VICTORIA RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:VICTORIA RESIDENTIAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLUSOLA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:AKINKUADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-502-6187
Mailing Address - Street 1:5919 WARWICK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-1446
Mailing Address - Country:US
Mailing Address - Phone:804-276-6477
Mailing Address - Fax:804-276-6477
Practice Address - Street 1:5919 WARWICK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-1446
Practice Address - Country:US
Practice Address - Phone:804-276-6477
Practice Address - Fax:804-276-6477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA876320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities