Provider Demographics
NPI:1134001910
Name:VICTORIOUS PRESTIGE WELLNESS AND ADVOCACY SERVICES LLC
Entity type:Organization
Organization Name:VICTORIOUS PRESTIGE WELLNESS AND ADVOCACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHWARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:219-617-4651
Mailing Address - Street 1:1707 BOCA LAGO DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3905
Mailing Address - Country:US
Mailing Address - Phone:219-617-4651
Mailing Address - Fax:
Practice Address - Street 1:1707 BOCA LAGO DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3905
Practice Address - Country:US
Practice Address - Phone:219-617-4651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care