Organization
VICTORY RESIDENTIAL CORPORATION
Active
Organization
VICTORY RESIDENTIAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. XAVIER ALEXANDER DAVIS (OWNER / CEO)
(612) 636-3194
Entity
Organization
Contact information
Practice address
1566 E JEANNE LN, SAN TAN VALLEY, AZ 85140-4046
(612) 636-3194
Mailing address
1566 E JEANNE LN, SAN TAN VALLEY, AZ 85140-4046
(612) 636-3194
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/16/2023
Last updated
06/19/2023
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