# VIC HOMECARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194198291
- **Authorized official:** VAN TRAN (PRESIDENT)
- **Authorized official phone:** (678) 575-1258

## Contact information

- **Practice address:** 1370 DORCHESTER AVE, SUITE 22B, DORCHESTER, MA 02122-2921
- **Practice address phone:** (678) 575-1258
- **Mailing address:** 1370 DORCHESTER AVE, SUITE 22B, DORCHESTER, MA 02122-2921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 11/20/2015