Provider Demographics
NPI:1396203279
Name:VRPSYCH LLC
Entity Type:Organization
Organization Name:VRPSYCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:201-600-0671
Mailing Address - Street 1:152 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-1353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:152 FOREST DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-1353
Practice Address - Country:US
Practice Address - Phone:201-600-0671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty