Active NPI
Baker Victory Services
- Nursing Facility/Intermediate Care Facility
- Lackawanna, NY
National Provider Identifier
1205047370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- RID1515VID00A00114
- Legal business name
- BAKER VICTORY SERVICES
- Practice address
- 150 Martin Road
Lackawanna, NY 14218 - Phone
- (716) 828-9751
- NPI assigned
- May 24, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey Daniel Almeter
- Title
- Comptroller
- Phone
- (716) 828-9751
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | RID1514VID00A00113B | NY | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | RID2794VID00A97001 | NY | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | RID1515VID00A00114 | NY | Primary |
Addresses
Primary practice location
150 Martin Road
Lackawanna, NY 14218
Mailing address
780 Ridge Road
Lackawanna, NY 14218
Phone (716) 828-9751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00465834 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1205047370. Details of each certification follow.
Psychiatric residential treatment facility certification: CCN 33L002
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- BAKER VICTORY SERVICES RTF
- Certification status
- Active
- Provider type (POS)
- Psychiatric residential treatment facility
- Participating since
- Dec 22, 2005
- Last certification
- Oct 20, 2022
- Beds
- 26
- Ownership / control type
- Non-profit – church related
- Facility address
- 150 Martin Road
Lackawanna, NY 14218
National Provider Directory
National Provider Directory- Tax ID family
- Baker Hall Inc
Other organizations with this tax ID 12
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Baker Victory Services
- Intellectual Disabilities Intermediate Care Facility
- Lackawanna, NY
- NPI 1023229192
-
dba OLV Human Services
- Nursing Facility/Intermediate Care Facility
- Lackawanna, NY
- NPI 1114138286
-
dba OLV Human Services
- Developmentally Disabled Services Day Training Agency
- Lackawanna, NY
- NPI 1669695391
-
dba OLV Human Services
- Community/Behavioral Health Agency
- Lackawanna, NY
- NPI 1124482344
-
dba Baker Victory Services
- Community/Behavioral Health Agency
- Lackawanna, NY
- NPI 1245352921
-
dba OLV Human Services
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Lackawanna, NY
- NPI 1285844084
-
dba OLV Human Services
- Psychiatric Residential Treatment Facility
- Lackawanna, NY
- NPI 1396956462
-
dba OLV Human services
- Nursing Facility/Intermediate Care Facility
- Lackawanna, NY
- NPI 1447461876
-
dba Baker Victory Services
- Intellectual Disabilities Intermediate Care Facility
- Lackawanna, NY
- NPI 1588875652
-
dba Baker Victory Services
- Early Intervention Provider Agency
- Lackawanna, NY
- NPI 1700013927
Locations
150 Martin Rd
Lackawanna, NY 14218
Phone (716) 828-9751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1205047370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 RIDGE ROAD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "14218",
"telephone_number": "716-828-9751",
"fax_number": "716-828-9450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 MARTIN ROAD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "14218",
"telephone_number": "716-828-9751"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAKER VICTORY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-24",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ALMETER",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "COMPTROLLER",
"authorized_official_telephone_number": "716-828-9751"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NY",
"license": "RID1514VID00A00113B",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NY",
"license": "RID2794VID00A97001",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NY",
"license": "RID1515VID00A00114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00465834",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lackawanna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.