Provider Demographics
NPI:1396371886
Name:INTELLIGENCE HEALTH GROUP INC
Entity Type:Organization
Organization Name:INTELLIGENCE HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YERALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICIANO CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-885-3227
Mailing Address - Street 1:PO BOX 3870
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 E. FORT KING STREET
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2315
Practice Address - Country:US
Practice Address - Phone:352-456-1070
Practice Address - Fax:352-608-9583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty