Provider Demographics
NPI:1174239750
Name:VICTORIOUS HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:VICTORIOUS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:ONYINYE
Authorized Official - Middle Name:U
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-318-3609
Mailing Address - Street 1:5 DAN RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2817
Mailing Address - Country:US
Mailing Address - Phone:781-318-3609
Mailing Address - Fax:781-318-8013
Practice Address - Street 1:5 DAN RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2817
Practice Address - Country:US
Practice Address - Phone:781-318-3609
Practice Address - Fax:781-318-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty