Organization
VICTORY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSAMUEDEMEN IYOHA MD (OWNER)
(734) 331-2088
Entity
Organization
Contact information
Practice address
5189 VENOY RD, WAYNE, MI 48184-2545
(734) 331-2088
Mailing address
3876 ELDER RD S, WEST BLOOMFIELD, MI 48324-2537
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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