Victa LLC
Internal Medicine, Addiction Medicine in Providence, Rhode Island
1104317007- Practice location
- 110 Elmwood Ave # A, Providence, RI 02907
- Phone
- 401-868-0654
- Fax
- —
- Last updated
- June 8, 2026
Victa LLC is a healthcare organization based in Providence, RI. Victa LLC practices in Providence, RI. The NPI Number for Victa LLC is 1104317007 and holds a License No. 648.01 (RI). The current practice location address for Victa LLC is 110 Elmwood Ave # A, Providence, RI 02907 and can be reached out via phone at 401-868-0654.
Provider Profile Details
- NPI Number
- 1104317007
- Provider Name
- Victa LLC
- Provider Entity Type
- Organization
- Address
- 110 Elmwood Ave # A, Providence, RI 02907
- Phone Number
- 401-868-0654
- Primary Taxonomy
- Internal Medicine, Addiction Medicine · 207RA0401X
- Organization Subpart
- No
- Authorized Official
- Mr. Alexander Donoyan · Ceo · 401-300-5757
- Provider Enumeration Date
- May 25, 2018
- Last Update Date
- June 8, 2026
- Certification Date
- June 8, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 110 Elmwood Ave # A
Providence, RI 02907 - City
- Providence
- State
- Rhode Island
- Zip
- 02907
- Phone Number
- 401-868-0654
Provider Business Mailing Address Details
- Address
- 110 Elmwood Ave
Providence, RI 02907-2423 - City
- Providence
- State
- RI
- Zip
- 02907-2423
- Phone Number
- 401-300-5757
- Fax Number
- 401-300-5656
License Information
- Taxonomy (1)
- Counselor · 101Y00000X
- License Number (2)
- 648.01
- License State (2)
- RI
- Taxonomy (2)
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X
- License Number (3)
- 648.01
- License State (3)
- RI
- Taxonomy (3)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- Taxonomy (4)
- Community Health Worker · 172V00000X
- Taxonomy (5)
- Psychologist, Addiction (Substance Use Disorder) · 103TA0400X
- Taxonomy (6)
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- Taxonomy (7)
- Marriage & Family Therapist · 106H00000X
- Taxonomy (8)
- Internal Medicine, Infectious Disease · 207RI0200X
- Taxonomy (9)
- Psychologist, Counseling · 103TC1900X
- Taxonomy (10)
- Registered Nurse, Ambulatory Care · 163WP2201X
- Taxonomy (11)
- Counselor, Mental Health · 101YM0800X
- Taxonomy (12)
- Registered Nurse, Addiction (Substance Use Disorder) · 163WA0400X
- Taxonomy (13)
- Peer Specialist · 175T00000X
- Taxonomy (14)
- Internal Medicine, Addiction Medicine · 207RA0401X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Internal Medicine, Addiction Medicine providers near Providence, RI
View all Internal Medicine, Addiction Medicine providers in Providence →- Alex Etienne, MDInternal Medicine, Addiction Medicine · NPI 1447221866
- Dr. Rahul Vanjani, MDInternal Medicine, Addiction Medicine · NPI 1134487135
- Laura J Henseler, MDInternal Medicine, Addiction Medicine · NPI 1073575049
- Prospect Chartercare Rwmc, LLCInternal Medicine, Addiction Medicine · NPI 1760977136
- Roger Williams Medical CenterInternal Medicine, Addiction Medicine · NPI 1457395998
- Seth ClarkInternal Medicine, Addiction Medicine · NPI 1801208798
Frequently Asked Questions
What is the NPI number of Victa LLC?
The NPI number of Victa LLC is 1104317007. It was assigned on May 25, 2018 and is currently active in the NPPES registry.
What is the specialty of Victa LLC?
Victa LLC is registered under the primary taxonomy Internal Medicine, Addiction Medicine (code 207RA0401X), licensed in RI under license number 648.01.
Where does Victa LLC practice?
The practice location is 110 Elmwood Ave # A, Providence, RI 02907. The office can be reached at 401-868-0654 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104317007 directly on the NPPES registry website.