Provider Demographics
NPI:1407691918
Name:VICTORY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:VICTORY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KATHURIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-793-5281
Mailing Address - Street 1:438 N FREDERICK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2555
Mailing Address - Country:US
Mailing Address - Phone:301-793-5281
Mailing Address - Fax:301-740-7668
Practice Address - Street 1:438 N FREDERICK AVE STE 300
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2555
Practice Address - Country:US
Practice Address - Phone:301-793-5281
Practice Address - Fax:301-740-7668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care