Victory Health Care Agency LLC

NPI #1306172747 in Detroit, Michigan

Provider Information

NPI Number
1306172747
Entity Type
Organization
Organization Name
Victory Health Care Agency LLC
Primary Specialty
Residential Treatment Facility, Physical Disabilities
Enumeration Date
Oct 20, 2009
Last Updated
Nov 23, 2010

Practice Location

Address
5555 CONNER AVE
Address 2
SUITE 3247
ZIP Code
48213
Phone
(313) 882-3303

Authorized Official

Name
JOAN DACOSTA, CNA
Title
MANGER
Phone
(313) 882-3303

Specialties & Taxonomy Codes

Specialty
Private Vehicle
Community Based Residential Treatment Facility, Mental Illness
Residential Treatment Facility, Physical Disabilities

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