Provider Demographics
NPI:1306194907
Name:INTELLIHEALTH, LLC
Entity type:Organization
Organization Name:INTELLIHEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-238-0266
Mailing Address - Street 1:6228 DONNINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:MD
Mailing Address - Zip Code:32438
Mailing Address - Country:US
Mailing Address - Phone:410-365-6524
Mailing Address - Fax:
Practice Address - Street 1:6228 DONNINGTON CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238
Practice Address - Country:US
Practice Address - Phone:410-365-6524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW109591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty