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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

VICTA LLC

Active Organization

VICTA LLC is a Addiction Medicine (Internal Medicine) organization located in PROVIDENCE, Rhode Island. NPI 1104317007 is currently active in the NPPES registry. Verify at CMS.

Addiction Medicine (Internal Medicine) · PROVIDENCE, RI

Registration Details

NPI Number
1104317007
Provider Type
Organization
NPI Issued
May 25, 2018 (8.2213854272359 yrs)
Last Updated
Dec 10, 2025
Licenses
648.01 (RI)
648.01 (RI)

Practice Information

Address
110 ELMWOOD AVE # A
PROVIDENCE, RI, 02907
Browse RI providers · Browse ZIP 02907
Phone
4018680654
Primary Specialty
Addiction Medicine (Internal Medicine)
207RA0401X
Additional Specialty
Mental Health Clinic
Additional Specialty
Counselor

Other Addiction Medicine (Internal Medicine) Organizations in PROVIDENCE, RI

Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.