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Organization
VICTORIOUS HEALTHCARE L.L.C.
Active
Organization
VICTORIOUS HEALTHCARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JEAN BEN (C.E. O.)
(601) 209-4278
Entity
Organization
Contact information
Practice address
4959 LAUREL OAK DR, JACKSON, MS 39212-2150
(601) 209-4278
Mailing address
4959 LAUREL OAK DR, JACKSON, MS 39212-2150
(601) 209-4278
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
313M00000X
Nursing Facility/Intermediate Care Facility
—
NULL
314000000X
Skilled Nursing Facility
—
NULL
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
332BN1400X
Nursing Facility Supplies (DME)
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
—
NULL
332U00000X
Home Delivered Meals
—
NULL
343800000X
Secured Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
—
NULL
385H00000X
Respite Care
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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