Organization
VICTORY PALACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IME ETUK (MANAGING DIRECTOR)
(616) 881-3843
Entity
Organization
Contact information
Practice address
908 COLLEGE AVE NE, GRAND RAPIDS, MI 49503-1751
(616) 214-8155
(616) 214-8155
Mailing address
908 COLLEGE AVE NE, GRAND RAPIDS, MI 49503-1751
(616) 214-8155
(616) 214-8155
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AF410306794
MI
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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