Provider Demographics
NPI:1588911044
Name:INTELLI, LLC
Entity type:Organization
Organization Name:INTELLI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:TOUSSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-484-8033
Mailing Address - Street 1:4000 HOLLYWOOD BLVD STE 555S
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6751
Mailing Address - Country:US
Mailing Address - Phone:305-484-8033
Mailing Address - Fax:
Practice Address - Street 1:1935 NW 134TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-1453
Practice Address - Country:US
Practice Address - Phone:305-484-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231563253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care