Victory Centre of Sierra Ridge LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VICTORY CENTRE OF SIERRA RIDGE LLC

Practice address

4150 W. Gatling Boulevard
Country Club Hills, IL 60478-2024

Phone

(708) 957-8300

Fax

(708) 206-1499

NPI assigned

Oct 1, 2007

Organization subpart

Yes

Parent organization

PATHWAY MANAGEMENT, LLCAs reported in NPPES

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

Authorized official

Name

Kristen Becht

Title

Risk Manager

Phone

(312) 837-0710

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1720275084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S WACKER DR STE 1010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606067413",
            "telephone_number": "312-837-0701",
            "fax_number": "312-837-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 W. GATLING BOULEVARD",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604782024",
            "telephone_number": "708-957-8300",
            "fax_number": "708-206-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY CENTRE OF SIERRA RIDGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAY MANAGEMENT, LLC",
        "enumeration_date": "2007-10-01",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "BECHT",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "RISK MANAGER",
        "authorized_official_telephone_number": "312-837-0710"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.