Provider Demographics
NPI:1184049645
Name:VICTORY UNTO SALVATION FAITH MINISTRIES
Entity type:Organization
Organization Name:VICTORY UNTO SALVATION FAITH MINISTRIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-828-2202
Mailing Address - Street 1:18066 JAMES COUZENS FWY
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2646
Mailing Address - Country:US
Mailing Address - Phone:313-828-2202
Mailing Address - Fax:
Practice Address - Street 1:277 PHILIP ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-3141
Practice Address - Country:US
Practice Address - Phone:313-207-0622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251F00000X, 251E00000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)