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Contact Information

INTELLISTARS THERAPY
275 UPPER RIVERDALE RD STE D
RIVERDALE, GA30274-2556
 Phone: 248-770-3658
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Adult Development & Aging

103TA0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for INTELLISTARS THERAPY

NPI # 1790355618
LBN Legal business name INTELLISTARS THERAPY
Authorized official MIRIAM GREENWALD - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/01/2021
Last updated 12/10/2025 - About 6 months ago
Identifiers
NJ Other 0450671179 STATE OF NJ
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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