Victory Home Health Care, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

HC3021 Issued in NC

Legal business name

VICTORY HOME HEALTH CARE, LLC

Practice address

1519 W Garrison Blvd
Gastonia, NC 28052-3671

Phone

(704) 759-4225

Fax

(980) 289-1302

NPI assigned

Jan 5, 2017

Organization subpart

No

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

Authorized official

Name

Debra N Okowa

Title

Director

Phone

(980) 418-8225

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1508301185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8501 TOWER POINT DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277849",
            "telephone_number": "704-841-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 W GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280523671",
            "telephone_number": "704-759-4225",
            "fax_number": "980-289-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "OKOWA",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "980-418-8225"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC3021",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC3021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC3021",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Gastonia, NC
• Providers in Gastonia, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.