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General NPI Number Information
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NPI Number | 1972673127
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Entity Type | Organization
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Legal Business Name | VICTORY HOME CARE INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 24634 FIVE MILE ROAD SUITE 1
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City | REDFORD
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State | MI
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Zip | 48239-3631
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Country | US
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Telephone | 313-535-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 24634 5 MILE RD SUITE 1
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City | REDFORD
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State | MI
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Zip | 48239-3631
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Country | US
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Telephone | 313-535-1777
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CALLISTA CHINWE UGORJI
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Credential | MBA
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Telephone | 313-535-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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