Victory 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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.