Organization
HUMBLE VICTORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN MAURICE HENDLEY (OWNER)
(813) 493-1516
Entity
Organization
Contact information
Practice address
11534 ASHTON FIELD AVE, RIVERVIEW, FL 33579-2374
(772) 261-4591
(813) 513-4390
Mailing address
11534 ASHTON FIELD AVE, RIVERVIEW, FL 33579-2374
(772) 261-4591
(813) 513-4390
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251F00000X
Home Infusion Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/10/2018
Last updated
12/12/2018
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