NPIMap

Organization Active NPI

Victory Healthcare Services LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Baltimore, MD
National Provider Identifier
1841021573
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Legal business name
VICTORY HEALTHCARE SERVICES LLC
Doing business as
victory healthcare services LLC
Practice address
1900 E .Northern Park Way Suite205-207
Baltimore, MD 21239-3777
Phone
(443) 529-9099
NPI assigned
Aug 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Bode Akadri
Title
Ceo
Phone
(443) 529-9099

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

1900 E .Northern Park Way Suite205-207
Baltimore, MD 21239-3777

Mailing address

1900 E .Northern Park Way Suite205-207
207
Baltimore, MD 21239-3777
Phone (443) 529-9099

Other names 1

  • victory healthcare services LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Victory Health Care Services LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1900 E Northern Pkwy
Ste 205207
Baltimore, MD 21239
Phone (443) 204-5144

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1841021573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E .NORTHERN PARK WAY SUITE205-207",
            "address_2": "207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212393777",
            "telephone_number": "443-529-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E .NORTHERN PARK WAY SUITE205-207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212393777",
            "telephone_number": "443-529-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "AKADRI",
        "authorized_official_first_name": "BODE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-529-9099"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "victory healthcare services LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "victory healthcare services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.