Provider Demographics
NPI:1306078100
Name:V I C (VICTORY IN CRISIS), INC
Entity type:Organization
Organization Name:V I C (VICTORY IN CRISIS), INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:DANIELLA
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-641-5722
Mailing Address - Street 1:PO BOX 11599
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-0599
Mailing Address - Country:US
Mailing Address - Phone:919-641-5722
Mailing Address - Fax:919-490-4416
Practice Address - Street 1:1800 MARTIN LUTHER KING PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3500
Practice Address - Country:US
Practice Address - Phone:919-641-5722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:V I C ( VICTORY IN CRISIS)
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)