Provider Demographics
NPI:1477219293
Name:INTELLAPLAY LLC
Entity Type:Organization
Organization Name:INTELLAPLAY LLC
Other - Org Name:INTELLAPLAY ABA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-676-6426
Mailing Address - Street 1:545 E COUNTY LINE RD STE 17B
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1487
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:153 LEEDER HILL DR
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-2731
Practice Address - Country:US
Practice Address - Phone:917-676-6426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty