Victory Clinical Services Ii Llc
Health Service - Psychology Clinic
4218 W Western Ave, South Bend
Indiana, 46619-2622
574-233-1524 574-233-1612
Maps & DirectionsVictory Clinical Services Ii Llc is a Health Service - Psychology Clinic in South Bend, Indiana. It is located at 4218 W Western Ave, South Bend, IN and its contact number is 574-233-1524. The authorized person for Victory Clinical Services Ii Llc is Mr. David Blankenship
who is Administrative Director of the clinic and his/her contact number is 574-233-1524. The primary license number for Victory Clinical Services Ii Llc is 02001493A (Addiction Medicine) in Indiana.
Victory Clinical Services Ii Llc Clinic is certified/licensed at the independent practice level in his/her state, and is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Complete Clinic Profile:
Victory Clinical Services Ii Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Victory Clinical Services Ii Llc |
| Specialization: | Health Service Psychology |
| Clinic Address: | 4218 W Western Ave, South Bend,
Indiana, 46619-2622 |
| Phone: | 574-233-1524 |
| Fax: | 574-233-1612 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Mr. David Blankenship |
| Position: | Administrative Director |
| Contact Number: | 574-233-1524 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Victory Clinical Services Ii Llc clinic are as mentioned below.
| NPI Number: | 1497798284 |
| NPI Enumeration Date: | 13 Jun, 2006 |
| NPI Last Update On: | 22 Mar, 2012 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Victory Clinical Services Ii Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Addiction Medicine | 02001493A | Indiana | Primary | |
| Health Service | 20010221A | Indiana | Secondary | |
| Nurse Practitioner | 71001833A | Indiana | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1255432233 | Other | Indiana | Woodward Npc - Npi |
| 168750 | Medicaid | Indiana | |
| 100220790 | Medicaid | Indiana | |
| 200495610 | Medicaid | Indiana | |
| 1518055565 | Other | Indiana | Sheehan Hspp - Npi |
| 1982647434 | Other | Indiana | Wang - Npi |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Victory Clinical Services Ii Llc
4218 W Western Ave,
South Bend, Indiana |
| Zip: | 46619-2622 |
| Phone Number: | 574-233-1524 |
| Fax Number: | 574-233-1612 |
Patients can reach Victory Clinical Services Ii Llc at
4218 W Western Ave, South Bend, Indiana or can
call to book an appointment on 574-233-1524.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.