VICTORY LIFE HEALTH SERVICES


Address: 95 E High St Ste 104, Waynesburg, PA 15370-1853
Phone: 7164561225

VICTORY LIFE HEALTH SERVICES (NPI# 1366806358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366806358
Entity Type Organization
Organization Name VICTORY LIFE HEALTH SERVICES
Other Organization Name THE BRIDGE INTO WELLNESS CENTER
Practice Address 95 E High St Ste 104
Waynesburg
PA 15370-1853
Mailing Address 6221 Route 474
Ashville
NY 14710-9788
Practice Telephone 7164561225
Mailing Telephone 7167824158
Enumeration Date 2016-04-06
Last Update Date 2016-04-06
Authorized Official Name MARISA TERRY (OWNER)
Authorized Official Telephone 7164561225
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
The Bridge into Wellness Center Doing Business As Name - Organization

Office Location

Street Address 95 E HIGH ST STE 104
City WAYNESBURG
State PA
Zip Code 15370-1853

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1124555370 Rebekah Barbara Matta Specialist/Technologist 51 West College St., Waynesburg, PA 15370 2017-05-18
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1578896106 Sue-ann R Woods Occupational Therapist 160 Greene Plaza, Waynesburg, PA 15370 2009-09-15
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Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1851958763 Hope Recovery Services LLC Family Medicine 200 Mcknight Park Dr Ste 201, Pittsburgh, PA 15237-6507 2019-05-27
1992281125 Aurora Recovery Services, LLC Family Medicine 993 Brodhead Rd Ste 201, Moon Twp, PA 15108 2018-07-11
1821503038 Philly Newlife Suboxone Clinics Family Medicine 3477 Saint Vincent St, Philadelphia, PA 19149-1628 2017-12-11
1447609565 Recovery Care LLC Family Medicine 2057 State Route 130 # 3, Jeannette, PA 15644-3801 2016-06-09
1154662062 William Francis Hushion I Family Medicine 1066 Putnam Blvd, Wallingford, PA 19086-6747 2013-03-04
1740570886 Germantown Pain Management & Physical Therapy Family Medicine 6334 Germantown Ave, Philadelphia, PA 19144-1935 2011-04-11
1649584459 Meridian Recovery Services Inc Family Medicine 2626 Sigsbee St, Erie, PA 16508-1721 2010-08-04
1265754998 Amc Health Family Medicine 2626 Sigsbee Street, Erie, PA 16508-1808 2010-02-22
1629201314 Cottman & Castor Pain Management Family Medicine 1934 Cottman Ave, Philadelphia, PA 19111-3817 2009-08-27
1992948038 Frankford Medical and Pain Management LLC Family Medicine 4911 Frankford Ave, Philadelphia, PA 19124-2617 2009-04-17
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Competitor

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City WAYNESBURG
Zip Code 15370

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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