Provider Demographics
NPI:1457941957
Name:FROM DEFEAT 2 VICTORY, LLC
Entity Type:Organization
Organization Name:FROM DEFEAT 2 VICTORY, LLC
Other - Org Name:VICTORY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:512-783-2188
Mailing Address - Street 1:3422 BUSINESS CENTER DRIVE
Mailing Address - Street 2:SUITE 106 #1132
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4215
Mailing Address - Country:US
Mailing Address - Phone:512-783-2188
Mailing Address - Fax:281-603-1728
Practice Address - Street 1:3422 BUSINESS CENTER DR STE 106
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4159
Practice Address - Country:US
Practice Address - Phone:512-783-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FROM DEFEAT 2 VICTORY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-19
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health