| Organization Name: | VICTORIAN SQUARE, LLC |
| NPI Number: | 1710180955 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RALPH H BELLANDE (MANAGING PARTNER) |
| Mailing Address: | 241 S Chamberlain Ave Rockwood |
| State: | TN US |
| Postal Code: | 378546542 |
| Phone Number: | 8653541133 |
| Fax Number: | 8653546371 |
| NPI Enumeration Date: | 06/06/2007 |
| NPI Last Update Date: | 01/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3104A0625X |
| License Number: | ACL0000000147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | Assisted Living, Mental Illness |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |