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Organization

VICTORIA HOUSE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA E. GLENN (OWNER & DIRECTOR)
(850) 584-2314
Entity
Organization

Contact information

Practice address
907 W WILCOX ST, PERRY, FL 32347-2422
(850) 584-7408
(850) 223-1244
Mailing address
1752 MORGAN WHIDDON RD, PERRY, FL 32347-2145
(850) 584-2314
(850) 223-1244

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
347C00000X
Private Vehicle
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
02/12/2008
Last updated
02/12/2008
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