Organization
VICTORY MANOR GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CANDI SEVERSON (OWNER)
(863) 313-3122
Entity
Organization
Contact information
Practice address
396 ABERDEEN DR, DAVENPORT, FL 33896-8397
(863) 313-3122
Mailing address
396 ABERDEEN DR, DAVENPORT, FL 33896-8397
(863) 313-3122
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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