Provider Demographics
NPI:1962156166
Name:VICTORY LIVING PROGRAMS
Entity type:Organization
Organization Name:VICTORY LIVING PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE-THOMASSET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-985-5400
Mailing Address - Street 1:1001 W CYPRESS CREEK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1951
Mailing Address - Country:US
Mailing Address - Phone:954-616-1074
Mailing Address - Fax:
Practice Address - Street 1:1001 W CYPRESS CREEK RD STE 400
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1951
Practice Address - Country:US
Practice Address - Phone:954-616-1074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services