Victory Ridge Academy, Inc.

LBN: Victory Ridge Academy, Inc.
Victory Ridge Academy, Inc. is an health care organization with primary practice located at 501 Burns Ave , Lake Wales FL 33853-3335. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Victory Ridge Academy, Inc. can be contacted via phone (863) 679-3338, or through Whitaker, Steven via phone (863) 679-3338.

Contact Information

Primary practice address
501 Burns Ave Lake Wales FL 33853-3335
Phone: (863) 679-3338
Fax: (863) 679-3944
Website:
Map and Directions
Authorized official contact:
Name: Whitaker, Steven
Phone: (863) 679-3338

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X Florida
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1184044612
LBN Legal business name Victory Ridge Academy, Inc.
DBA Doing business as
Authorized official Whitaker, Steven
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2014
Last updated Nov 8th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184044612 NPPES
Florida MEDICAID 010977000

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