Victa Llc

LBN: Victa Llc
Victa Llc is an health care organization with primary practice located at 110 Elmwood Ave , Providence RI 02907-2423. The organization recently has only one registered license in Ambulatory Health Care Facilities / Methadone, which is considered as the primary health care specialty. Victa Llc can be contacted via phone (401) 300-5757, or through Donoyan, Alexander via phone (401) 300-5757.

Contact Information

Primary practice address
110 Elmwood Ave Providence RI 02907-2423
Phone: (401) 300-5757
Fax: (401) 300-5656
Website:
Map and Directions
Authorized official contact:
Name: Donoyan, Alexander MBA, LCDP
Phone: (401) 300-5757

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Methadone 261QM2800X

Profile Details

NPI number 1457822413
LBN Legal business name Victa Llc
DBA Doing business as
Authorized official Donoyan, Alexander MBA, LCDP
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2018
Last updated Feb 21st, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457822413 NPPES
Rhode Island MEDICAID 1104317007

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