Organization
VICTORY HEALTH HOME PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IBUKUN ODUTOLA PMHNP (DNP CEO)
(480) 202-4597
Entity
Organization
Contact information
Practice address
3887 E CITRINE RD, SAN TAN VALLEY, AZ 85143-5688
(602) 502-4872
(480) 210-3563
Mailing address
3887 E CITRINE RD, SAN TAN VALLEY, AZ 85143-5688
(480) 202-4597
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
01/15/2026
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