Victory at Home Care LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

VICTORY AT HOME CARE LLC

Practice address

2812 Park Springs Dr
Grand Prairie, TX 75052-8529

Phone

(888) 588-1049

NPI assigned

Jan 18, 2022

Organization subpart

No

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

Authorized official

Name

Rosaline Wahome

Title

Manager

Phone

(888) 588-1049

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1386395614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 PARK SPRINGS DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528529",
            "telephone_number": "888-588-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 PARK SPRINGS DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528529",
            "telephone_number": "888-588-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY AT HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "WAHOME",
        "authorized_official_first_name": "ROSALINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "888-588-1049"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Grand Prairie, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.