VICTA LLC

PROVIDENCE, RI
NPI1104317007
Entity TypeOrganization
Authorized ContactALEXANDER DONOYAN
CEO
401-300-5757
Organization Subpart ?No
Primary Taxonomy207RA0401X Internal Medicine, Addiction Medicine
Additional Taxonomies207RI0200X Internal Medicine, Infectious Disease
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
(Licence: RI  648.01)
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
(Licence: RI  648.01)
101Y00000X Counselor
101YA0400X Counselor, Addiction (Substance Use Disorder)
101YM0800X Counselor, Mental Health
103TA0400X Psychologist, Addiction (Substance Use Disorder)
103TC1900X Psychologist, Counseling
106H00000X Marriage & Family Therapist
133NN1002X Nutritionist, Nutrition, Education
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
163WP2201X Registered Nurse, Ambulatory Care
Enumeration Date2018-05-25
Last Update Date2019-02-21
Business Address
VICTA LLC
110 ELMWOOD AVE # A
PROVIDENCE, RI 02907
Phone number: 401-868-0654
Mailing Address
VICTA LLC
110 ELMWOOD AVE
PROVIDENCE, RI 02907-2423
Phone number: 401-300-5757