Provider Demographics
NPI:1952996555
Name:INTELLI-DATA SOLUTIONS GROUP
Entity Type:Organization
Organization Name:INTELLI-DATA SOLUTIONS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-339-5994
Mailing Address - Street 1:VILLAS DE LOIZA
Mailing Address - Street 2:SS9 CALLE 29
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:939-339-5994
Mailing Address - Fax:
Practice Address - Street 1:VILLAS DE LOIZA
Practice Address - Street 2:SS9 CALLE 29
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:939-339-5994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable