Victory Community Services, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

012287100 Issued in FL

Legal business name

VICTORY COMMUNITY SERVICES, INC.

Practice address

20535 NW 2ND Ave
Suite 202
Miami Gardens, FL 33169-2547

Phone

(305) 974-5299

Fax

(786) 320-6026

NPI assigned

Aug 26, 2015

Last updated

Aug 26, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Victor Amaechi Minikwu Sr., CMHP, CPP

Title

Executive Director

Phone

(305) 974-5299

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1174990162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20535 NW 2ND AVE",
            "address_2": "SUITE 202",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331692547",
            "telephone_number": "305-974-5299",
            "fax_number": "786-320-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20535 NW 2ND AVE",
            "address_2": "SUITE 202",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331692547",
            "telephone_number": "305-974-5299",
            "fax_number": "786-320-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "MINIKWU",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "AMAECHI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "305-974-5299",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "CMHP, CPP"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "012287100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012287100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Maydelin L Vidal
• Maria Elena Vigoa
• Betsy Vila Curbelo

• In Home Supportive Care Agency in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.