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Organization
VICTORY HOME HEALTH, PALLIATIVE, WAIVER SERVICES, INC,
Active
Organization
VICTORY HOME HEALTH, PALLIATIVE, WAIVER SERVICES, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA L PADILLA RN (EXECUTIVE DIRECTOR)
(505) 454-0499
Entity
Organization
Contact information
Practice address
416 STATE ST STE 62, TRINIDAD, CO 81082-2402
(719) 845-1166
(505) 454-0499
Mailing address
2810 HOT SPRINGS BLVD, LAS VEGAS, NM 87701-4119
(505) 454-0499
(505) 425-9105
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
067458
CO
Other
Enumeration date
08/12/2006
Last updated
11/19/2007
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