Victory Bay Mental Health LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VICTORY BAY MENTAL HEALTH LLC

Practice address

8445 Keystone Xing Ste 180
Indianapolis, IN 46240-0020

Phone

(856) 454-3104

NPI assigned

Jul 24, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Mellon

Title

Director of Regulatory Compliance &

Phone

(856) 282-5590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1720816432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 EVES DR STE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533196",
            "telephone_number": "856-282-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 KEYSTONE XING STE 180",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462400020",
            "telephone_number": "856-454-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY BAY MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MELLON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF REGULATORY COMPLIANCE &",
        "authorized_official_telephone_number": "856-282-5590"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.