Victory Village

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PCH008447 Issued in GA

Legal business name

VICTORY VILLAGE

Practice address

3650 Salem Church Rd
Jasper, GA 30143-5288

Phone

(770) 735-2219

Fax

(770) 828-0698

NPI assigned

Mar 3, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Tammy Lynn Crider

Title

Owner/Administrator

Phone

(770) 735-2219

Specialties & licenses 1

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": "1520035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1912409137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SALEM CHURCH RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435288",
            "telephone_number": "770-735-2219",
            "fax_number": "770-828-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SALEM CHURCH RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301435288",
            "telephone_number": "770-735-2219",
            "fax_number": "770-828-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-03",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "CRIDER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "770-735-2219",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PCH008447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Rehab Inc
• Uplift Pelvic Health, LLC
• Ashley Valderrama, MS, CCC-SLP
• Van Tuyl Dental Group
• Richard J Vandam, M.D.
• Village Podiatry Group, LLC
• Village Podiatry Group, LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Walgreen Co

• Assisted Living Facility in Jasper, GA
• Providers in Jasper, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.