VICTORY VILLAGE
NPI 1912409137
Assisted Living Facility in Jasper, GA

Q: What is Victory Village's NPI number?

The NPI number for Victory Village is 1912409137. It was assigned to this organization in the NPPES registry on March 3, 2018.

Q: What is Victory Village's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Victory Village was last updated on March 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 03, 2018CLIA 11D2125695 · Waiver

3650 SALEM CHURCH RD, JASPER, GA 30143(770) 735-2219(770) 828-0698 Get Directions Write a Review

NPPES record last updated: March 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Victory Village NPPES

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

VICTORY VILLAGE (NPI 1912409137) is a healthcare organization registered as an assisted living facility in Jasper, Georgia and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through February 12, 2027 and lists Tammy Lynn Crider, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1912409137

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameVICTORY VILLAGE

Location Address3650 SALEM CHURCH RDJasper, GA 30143-5288

Mailing Address3650 Salem Church RdJasper, GA 30143-5288 · (770) 735-2219 · Fax (770) 828-0698

Phone(770) 735-2219

Fax(770) 828-0698

Organization SubpartNo

Authorized OfficialTammy Lynn CriderOwner/administrator · (770) 735-2219

Enumeration DateMarch 3, 2018

Last NPPES UpdateMarch 11, 2024

NPPES CertifiedMarch 11, 2024

✔ NPI 1912409137 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in GA · PCH008447

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

3650 SALEM CHURCH RD, Jasper, GA 30143

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2125695

Victory Village, Pch · Jasper, GA

Active · expires Feb 12, 2027

CLIA Number11D2125695

Laboratory TypeAssisted Living Facility

Certificate Effective DateFebruary 13, 2025

Certificate Expiration DateFebruary 12, 2027

Laboratory DirectorTammy Crider Kindle

Laboratory Phone(770) 735-2219

Laboratory LocationVictory Village, Pch3650 Salem Church Road, Jasper, GA 30143

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Village's NPI number?

The NPI number for Victory Village is 1912409137. It was assigned to this organization in the NPPES registry on March 3, 2018.

Where is Victory Village located?

Victory Village is located at 3650 Salem Church Rd, Jasper, GA 30143. The listed phone number is (770) 735-2219.

What is Victory Village's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Victory Village hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2125695) is associated with this NPI, valid through February 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Victory Village was last updated on March 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.