Provider Demographics
NPI:1386394682
Name:VICTORY SERVICES LLC
Entity type:Organization
Organization Name:VICTORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:JONES
Authorized Official - Suffix:II
Authorized Official - Credentials:MED
Authorized Official - Phone:804-878-7095
Mailing Address - Street 1:716 BISMARCK MYRICK ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-4131
Mailing Address - Country:US
Mailing Address - Phone:804-878-7095
Mailing Address - Fax:
Practice Address - Street 1:716 BISMARCK MYRICK ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-4131
Practice Address - Country:US
Practice Address - Phone:804-878-7095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services