NPI 1104317007
Victa LLC
Practice location
- Address
- 110 Elmwood Ave # a, Providence, RI 02907
- Phone
- (401) 868-0654
- Mailing address
- 110 Elmwood Ave, Providence, RI 02907-2423
Authorised official
- Name
- Alexander Donoyan
- Title
- Ceo
- Phone
- (401) 300-5757
Registered specialties (14)
Addiction Medicine (Internal Medicine) Physician
Primary
Addiction (Substance Use Disorder) Counselor
Mental Health Counselor
Addiction (Substance Use Disorder) Psychologist
Counseling Psychologist
Marriage & Family Therapist
Addiction (Substance Use Disorder) Registered Nurse
Ambulatory Care Registered Nurse
Community Health Worker
Peer Specialist
Infectious Disease Physician
Mental Health Clinic/Center (Including Community Mental Health Center)
Substance Use Disorder Rehabilitation Clinic/Center
Registry record
- NPI
- 1104317007
- Entity type
- Organization
- NPI issued
- 25 May 2018
- Record last updated
- 8 Jun 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.