Victa LLC
NPI #1457822413 in Providence, Rhode Island
Provider Information
- NPI Number
- 1457822413
- Entity Type
- Organization
- Organization Name
- Victa LLC
- Primary Specialty
- Clinic/Center - Methadone
- Enumeration Date
- Dec 16, 2018
- Last Updated
- Feb 21, 2019
Practice Location
- Address
- 110 ELMWOOD AVE
- City
- Providence
- State
- Rhode Island
- ZIP Code
- 02907-2423
- Phone
- (401) 300-5757
Authorized Official
- Name
- MR. ALEXANDER DONOYAN, MBA, LCDP
- Title
- CEO
- Phone
- (401) 300-5757
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Methadone — Methadone |
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