Organization · NPI-2

A Victorious Home Care

Home Health · Concord, NC

NPI number1417199712
StatusActive
Last updated in NPPESOct 28, 2011

Details

NPI
1417199712
Entity type
Organization (NPI-2)
Legal business name
A Victorious Home Care
Organization subpart
No
Enumeration date
Apr 1, 2009
Last updated
Oct 28, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home HealthHC3794NCYes

Practice location

135 Cabarrus Ave E
Concord, NC 28025-3469

Phone 704-865-0718 · Fax 704-865-0720

Mailing address

3549 N Sharon Amity Rd Ste 301
Charlotte, NC 28205-2975

Phone 704-535-0995 · Fax 704-536-4373

Authorized official

Ike Ifedi
Director
7045350995

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