- Enrollment id
- O20031226000261
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1508079674
- Multiple npi flag
- N
- Ccn
- 679481
- Associate id
- 2769380898
- Organization name
- VICTORY INSTITUTE, INC
- Doing business as name
- AFFORDABLE HOME HEALTH
- Incorporation date
- 1999-06-01
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 12115 SELF PLAZA DR.
- City
- DALLAS
- State
- TX
- Zip code
- 752181469