Victory Health Home PLLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

VICTORY HEALTH HOME PLLC

Practice address

9132 W Hubbell St
Phoenix, AZ 85037-4377

Phone

(407) 738-5791

Fax

(480) 210-3563

NPI assigned

Mar 4, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Ibukun Odutola, DNP

Title

Ceo

Phone

(480) 202-4597

Specialties & licenses 1

Addresses

Tax ID family

Victory Health Home PLLC2 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.

• Victory Health Home PLLC

  • Mental Illness Community Based Residential Treatment Facility
  • San Tan Valley, AZ
  • NPI 1487431805
  NPD tax ID

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1609633080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9132 W HUBBELL ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9132 W HUBBELL ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374377",
            "telephone_number": "407-738-5791",
            "fax_number": "480-210-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HEALTH HOME PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "ODUTOLA",
        "authorized_official_first_name": "IBUKUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-202-4597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victorious Lifestyle LLC
• Victory Behavioral Healthcare PLLC
• Victory Collegiate Academy Corp.
• Victory Group Home LLC
• Victory Group Home LLC#2
• Victory Sports Therapy, PLLC
• Vidadyne Healthcare LLC
• Edward Vidal, FNP
• Maria Vidale
• Michelle Vidaure, FNP

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.