Organization
VICTORY HOME HEALTH, LLC
Active
Other names
Victory Home Health and Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
KIM CRIPPS RN (ADMINISTRATOR)
(580) 371-2002
Entity
Organization
Contact information
Practice address
104 THOMA DR STE 1, BOX 769, ELGIN, OK 73538-2203
(580) 492-6166
(580) 492-6160
Mailing address
714 E MAIN ST, TISHOMINGO, OK 73460-2350
(580) 371-2002
(580) 371-2262
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7767
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100262440B
—
OK
05
—
100262440C
—
OK
05
—
100262440K
—
OK
05
—
100262440L
—
OK
Enumeration date
01/04/2006
Last updated
08/18/2016
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