Organization
VICTORY LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMAN F KAHSAI (EXECUTIVE DIRECTOR)
(707) 477-6293
Entity
Organization
Contact information
Practice address
16332 SW ESTUARY DR APT 205, BEAVERTON, OR 97006-7941
(707) 477-6293
Mailing address
16332 SW ESTUARY DR APT 205, BEAVERTON, OR 97006-7941
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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