Victory Rehabilitation and Healthcare Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1406 Issued in WA

Legal business name

VICTORY REHABILITATION AND HEALTHCARE CENTER, LLC

Practice address

510 N Parkway Ave
Battle Ground, WA 98604-8004

Phone

(360) 687-5141

Fax

(360) 687-1897

NPI assigned

Sep 28, 2007

Last updated

Mar 16, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

ORIANNA HEALTH SYSTEMS, LLCAs reported in NPPES

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

Authorized official

Name

Craig E Robinson

Title

President

Phone

(901) 937-7994

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1700073194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N PARKWAY AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986048004",
            "telephone_number": "360-687-5141",
            "fax_number": "360-687-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N PARKWAY AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986048004",
            "telephone_number": "360-687-5141",
            "fax_number": "360-687-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY REHABILITATION AND HEALTHCARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORIANNA HEALTH SYSTEMS, LLC",
        "enumeration_date": "2007-09-28",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-937-7994"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114062",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.