Provider Demographics
NPI:1174772602
Name:VIRTUAL HEALTHCARE NETWORK LLC
Entity type:Organization
Organization Name:VIRTUAL HEALTHCARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:O
Authorized Official - Last Name:CRANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-898-2689
Mailing Address - Street 1:PO BOX 50413
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0413
Mailing Address - Country:US
Mailing Address - Phone:702-898-2689
Mailing Address - Fax:702-898-2689
Practice Address - Street 1:275 GRAND TETON DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-4162
Practice Address - Country:US
Practice Address - Phone:702-898-2689
Practice Address - Fax:702-898-2689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty