| Organization Name: | VICTORIAN MANOR OF HERMANN INC |
| NPI Number: | 1750553830 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY L QUICK (SECRETARY) |
| Mailing Address: | 2120 Village Lane Hermann |
| State: | MO US |
| Postal Code: | 65041 |
| Phone Number: | 5734865060 |
| Fax Number: | 5734865080 |
| NPI Enumeration Date: | 03/28/2008 |
| NPI Last Update Date: | 03/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 032830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |