# VICTORY HOME CARE AGENCY LLC

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

## Provider details

- **NPI number:** 1972315414
- **Authorized official:** KHALILAH ODOM (MANAGER)
- **Authorized official phone:** (219) 229-4421

## Contact information

- **Practice address:** 2302 E MICHIGAN BLVD, MICHIGAN CITY, IN 46360-5372
- **Practice address phone:** (574) 334-3290
- **Mailing address:** 2302 E MICHIGAN BLVD, MICHIGAN CITY, IN 46360-5372
- **Mailing address phone:** (219) 229-4421
- **Mailing address fax:** (219) 200-2919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |

## Other

- **Enumeration date:** 01/22/2025
- **Last updated:** 10/21/2025