Victory Homes LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VICTORY HOMES LLC

Practice address

7917 Perry Ave N
Brooklyn Park, MN 55443-2418

Phone

(763) 321-1278

Fax

(888) 349-5754

NPI assigned

Oct 13, 2020

Organization subpart

No

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

Authorized official

Name

Sonie Kpanaku, RN, BSN, PHN

Title

Administrator, Owner

Phone

(763) 321-1278

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1770181679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7917 PERRY AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432418",
            "telephone_number": "763-321-1278",
            "fax_number": "888-349-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7917 PERRY AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554432418",
            "telephone_number": "763-321-1278",
            "fax_number": "888-349-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "KPANAKU",
        "authorized_official_first_name": "SONIE",
        "authorized_official_title_or_position": "ADMINISTRATOR, OWNER",
        "authorized_official_telephone_number": "763-321-1278",
        "authorized_official_credential": "RN, BSN, PHN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.