OrganizationActive
Victory Clinical Services II LLC
NPI 1497798284 · Addiction Medicine (Family Medicine) Physician · South Bend, IN
Provider details
- NPI number
- 1497798284
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- David Blankenship, Administrative Director
- License
- 20010221A (IN)
Practice location
4218 W Western Ave
South Bend, IN 46619-2622
Phone: (574) 233-1524
Fax: (574) 233-1612
Mailing address
4218 W Western Ave
South Bend, IN 46619-2622
Registry dates
- Enumerated
- 2006-06-13
- Last updated
- 2012-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.