Organization
VICTORY GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYNE DUSABE (ADMINISTRATOR)
(469) 648-8397
Entity
Organization
Contact information
Practice address
9127 W MINNEZONA AVE, PHOENIX, AZ 85037-2446
(469) 648-8397
Mailing address
9127 W MINNEZONA AVE, PHOENIX, AZ 85037-2446
(469) 648-8397
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6785
BH LICENSE
AZ
Enumeration date
08/06/2021
Last updated
08/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us