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VICTORY CLINICAL SERVICES II LLC
NPI 1497798284
Family Medicine - Addiction Medicine in South Bend, IN

Active since June 13, 2006
4218 W WESTERN AVE, SOUTH BEND, IN 46619(574) 233-1524(574) 233-1612 Get Directions Write a Review

NPPES record last updated: March 22, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Victory Clinical Services Ii Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTORY CLINICAL SERVICES II LLC (NPI 1497798284) is a healthcare organization registered as an addiction medicine in South Bend, Indiana and active in the NPI registry since June 2006. The organization lists David Blankenship, Administrative Director, as its authorized official.

NPPES Registry Identity

NPI1497798284
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameVICTORY CLINICAL SERVICES II LLC
Location Address4218 W WESTERN AVESouth Bend, IN 46619-2622
Mailing Address4218 W Western AveSouth Bend, IN 46619-2622 · (574) 233-1524 · Fax (574) 233-1612
Phone(574) 233-1524
Fax(574) 233-1612
Organization SubpartNo
Authorized OfficialDavid BlankenshipAdministrative Director · (574) 233-1524
Enumeration DateJune 13, 2006
Last NPPES UpdateMarch 22, 2012
✔ NPI 1497798284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
License✔ Licensed in IN · 02001493A
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Also ListedPsychologist · Health ServiceTaxonomy 103TH0100X · License 20010221A (IN)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 71001833A (IN)
4218 W WESTERN AVE, South Bend, IN 46619
Open in Google Maps ↗

Other Identifiers 11

Other1518055565IN · Sheehan Hspp - Npi
Other1255432233IN · Woodward Npc - Npi
Medicare UPIN5339542IN
Medicare ID-Type Unspecified090310IN · Sheehan Hspp
Medicaid168750IN
Medicaid100220790IN
Other1982647434IN · Wang - Npi
Medicare ID-Type Unspecified100324240AIN · Wang
Medicare UPIN2407033IN
Medicare UPIN000000375955IN
Medicaid200495610IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Priority Health.Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY FRANKLIN
Counselor
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
MRS. ERIN T. LACOURT LAC
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
DAVID BRINER
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
JOIE WROBLEWSKI
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
JOHN ANTHONY KRECEK MA,CAADC, MATS, CCJP
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
JOHN ANTHONY KRECEK MA,CAADC, MATS, CCJP
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524
IMANI INGRAM MPA, ACIT
Counselor (Addiction (Substance Use Disorder))
4218 W WESTERN AVE
SOUTH BEND, IN 46619
St. Joseph County (574) 233-1524

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Victory Clinical Services II LLC's NPI number?

The NPI number for Victory Clinical Services II LLC is 1497798284. It was assigned to this organization in the NPPES registry on June 13, 2006.

Where is Victory Clinical Services II LLC located?

Victory Clinical Services II LLC is located at 4218 W Western Ave, South Bend, IN 46619. The listed phone number is (574) 233-1524.

What is Victory Clinical Services II LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

What insurance does Victory Clinical Services II LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and Priority Health list Victory Clinical Services II LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Victory Clinical Services II LLC was last updated on March 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.