Victory Addiction Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

2203781178 Issued in LA

Legal business name

VICTORY ADDICTION RECOVERY CENTER

Practice address

111 Liberty Ave
Lafayette, LA 70508-6821

Phone

(337) 456-9111

Fax

(337) 456-9131

NPI assigned

Oct 11, 2012

Organization subpart

No

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

Authorized official

Name

David A. Legendre, PHD

Title

Ceo

Phone

(337) 456-9111

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1497007694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LIBERTY AVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086821",
            "telephone_number": "337-456-9111",
            "fax_number": "337-456-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LIBERTY AVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086821",
            "telephone_number": "337-456-9111",
            "fax_number": "337-456-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY ADDICTION RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "LEGENDRE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-456-9111",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": "2203781178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Viator
• William Vice
• Emily Andrea Vicknair, FNP
• Rohini B Vicknair, PA-C
• Laquenta Victor, B.S
• Carla Ann Vidrine, FNP-C
• Ethel Marie Vidrine, CRNA
• Melissa T Vidrine, LCSW
• Ryan Joseph Vidrine, DC
• Viemed Clinical Services, LLC

• Substance Abuse Rehabilitation Facility in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Substance Abuse Rehabilitation Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.