Provider Demographics
NPI:1568291524
Name:VICTORY ENTERPRISES AND VENTURES INC
Entity type:Organization
Organization Name:VICTORY ENTERPRISES AND VENTURES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRINEA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:561-385-9204
Mailing Address - Street 1:PO BOX 531352
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-8922
Mailing Address - Country:US
Mailing Address - Phone:561-385-9204
Mailing Address - Fax:
Practice Address - Street 1:1675 NW 4TH AVE APT 410
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1561
Practice Address - Country:US
Practice Address - Phone:561-707-6054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health