Organization
VICTORY HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIMBOLA OGUNLOLA RN,BSN (CEO)
(773) 507-6379
Entity
Organization
Contact information
Practice address
20105 REDWOOD AVE, LYNWOOD, IL 60411-6804
(773) 507-6379
(708) 251-5646
Mailing address
20139 DRIFTWOOD AVE, LYNWOOD, IL 60411-6812
(773) 507-6379
(708) 251-5646
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201700008C
IL
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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