Organization Active NPI

Victory Manor Group Home LLC

  • Developmentally Disabled Services Day Training Agency
  • Davenport, FL
National Provider Identifier
1619810462
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
VICTORY MANOR GROUP HOME LLC
Practice address
396 Aberdeen Dr
Davenport, FL 33896-8397
Phone
(863) 313-3122
NPI assigned
Apr 14, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Authorized official

Name
Ms. Candi Severson
Title
Owner
Phone
(863) 313-3122

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

396 Aberdeen Dr
Davenport, FL 33896-8397

Mailing address

396 Aberdeen Dr
Davenport, FL 33896-8397
Phone (863) 313-3122

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1619810462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 ABERDEEN DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338968397",
            "telephone_number": "863-313-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 ABERDEEN DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338968397",
            "telephone_number": "863-313-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MANOR GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "SEVERSON",
        "authorized_official_first_name": "CANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-313-3122",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.