NPIMap

Organization Active NPI

Victorious Mental Healthcare LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1265062467
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VICTORIOUS MENTAL HEALTHCARE LLC
Practice address
5006 Belair Rd
Baltimore, MD 21206-5101
Phone
(410) 488-5171
Fax
(410) 488-5173
NPI assigned
Jan 16, 2020
Last updated
Jan 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Authorized official

Name
Bosede Oluwatoyin Adetunji - IdowuNPI 1770113250
Title
Chief Executive Officer
Phone
(443) 540-0338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5006 Belair Rd
Baltimore, MD 21206-5101

Mailing address

5006 Belair Rd
Baltimore, MD 21206-5101
Phone (410) 488-5171

National Provider Directory

National Provider Directory
Tax ID family
Victorious Mental Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1265062467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065101",
            "telephone_number": "410-488-5171",
            "fax_number": "410-488-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065101",
            "telephone_number": "410-488-5171",
            "fax_number": "410-488-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIOUS MENTAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "ADETUNJI - IDOWU",
        "authorized_official_first_name": "BOSEDE",
        "authorized_official_middle_name": "OLUWATOYIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "443-540-0338"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.