Provider Demographics
NPI:1265047567
Name:VIRTUAL THERAPEUTIC CONNECT LLC
Entity type:Organization
Organization Name:VIRTUAL THERAPEUTIC CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBONE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:914-374-2601
Mailing Address - Street 1:85 CAMP AVE APT 11D
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-1840
Mailing Address - Country:US
Mailing Address - Phone:914-374-2601
Mailing Address - Fax:
Practice Address - Street 1:85 CAMP AVE APT 11D
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06907-1840
Practice Address - Country:US
Practice Address - Phone:914-374-2601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities