Provider Demographics
NPI:1356823900
Name:INTELLIWELLNESS LLC
Entity Type:Organization
Organization Name:INTELLIWELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHNUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-672-9989
Mailing Address - Street 1:4302 ALTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2818
Mailing Address - Country:US
Mailing Address - Phone:305-672-9989
Mailing Address - Fax:786-245-2006
Practice Address - Street 1:4302 ALTON RD STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2818
Practice Address - Country:US
Practice Address - Phone:305-672-9989
Practice Address - Fax:786-245-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management