Provider Demographics
NPI:1366737512
Name:VICTORY HELP OUTPATIENT DRUG AND ALCOHOL PROGRAM
Entity type:Organization
Organization Name:VICTORY HELP OUTPATIENT DRUG AND ALCOHOL PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOVSEP
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHABAKHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-781-1122
Mailing Address - Street 1:13762 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2324
Mailing Address - Country:US
Mailing Address - Phone:818-781-1122
Mailing Address - Fax:818-781-1199
Practice Address - Street 1:13762 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2324
Practice Address - Country:US
Practice Address - Phone:818-781-1122
Practice Address - Fax:818-781-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management