NPIMap

Organization Active NPI

Victory Mountain, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ironton, MO
National Provider Identifier
1295954741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
VICTORY MOUNTAIN, INC.
Practice address
HC 69 Box 1455
Ironton, MO 63650-9606
Phone
(573) 546-7592
Fax
(573) 546-0125
NPI assigned
Apr 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christopher Skinner, L.P.C.NPI 1063638302
Title
Director
Phone
(573) 546-7592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MO Primary

Addresses

Primary practice location

HC 69 Box 1455
Ironton, MO 63650-9606

Mailing address

HC 69 Box 1455
Ironton, MO 63650-9606
Phone (573) 546-7592

Other names 1

  • Victory Mountain Boys Ranch Other name

National Provider Directory

National Provider Directory
Tax ID family
Victory Mountain Boys Ranch2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295954741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 69 BOX 1455",
            "city": "IRONTON",
            "state": "MO",
            "postal_code": "636509606",
            "telephone_number": "573-546-7592",
            "fax_number": "573-546-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 69 BOX 1455",
            "city": "IRONTON",
            "state": "MO",
            "postal_code": "636509606",
            "telephone_number": "573-546-7592",
            "fax_number": "573-546-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MOUNTAIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-546-7592",
        "authorized_official_credential": "L.P.C."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Mountain Boys Ranch",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ironton, MO

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.