Victory NH Holding LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

VICTORY NH HOLDING LLC

Practice address

512 49TH Ave N
Minneapolis, MN 55430-3621

Phone

(612) 529-7747

NPI assigned

Sep 20, 2018

Organization subpart

No

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

Authorized official

Name

Israel Sherman

Title

President

Phone

(718) 983-9852

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Skilled nursing facility certification: CCN 245544

Legal name

VICTORY NH HOLDING, LLC

Doing business as

VICTORY HEALTH & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1991

Last certification

Dec 19, 2024

Beds

79

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Sep 13, 2018 in MN

Enrollment address

512 49TH Ave N
Minneapolis, MN 55430-3621

Nursing home name

VICTORY HEALTH AND REHABILITATION CENTER

Listed as

Victory Health and Rehabilitation CenterCCN 245544

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7970.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Victory Health Operations, LLC

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1144707811

  Member Of

  NPD member

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence J Kerzner, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Minneapolis, MN
  • NPI 1134175698
  NPD (past)
• Brian Lewis, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Golden Valley, MN
  • NPI 1235525015
  NPD (past)
• Clemencia Rasquinha, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Golden Valley, MN
  • NPI 1023021409
  NPD (past)

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1548744014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 49TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554303621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 49TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554303621",
            "telephone_number": "612-529-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY NH HOLDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-983-9852"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Vick
• Leo Fred Vickerman, LADC
• Katherine Diaz Vickery, MD, MSC
• Mollee Vicklund
• Victory Health Operations, LLC
• Victory Through Faith Recovery Services
• Victory Through Faith Recovery Servies
• Vida Transportation Service LLC
• Videll Healthcare Camden, L.L.C.
• Jared Joshua Vidervol

• Skilled Nursing Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.