Provider Demographics
NPI:1053983239
Name:VICTORIOUS CARE LLC
Entity type:Organization
Organization Name:VICTORIOUS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:X
Authorized Official - Last Name:COAD-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-345-7433
Mailing Address - Street 1:190 LORANE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-3408
Mailing Address - Country:US
Mailing Address - Phone:484-345-7433
Mailing Address - Fax:
Practice Address - Street 1:190 LORANE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3408
Practice Address - Country:US
Practice Address - Phone:484-345-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility