Organization
INTELLISTARS ABA NC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM GREENWALD MSED (CHIEF CARING OFFICER)
(248) 770-3658
Entity
Organization
Contact information
Practice address
525 N TRYON ST STE 1600, CHARLOTTE, NC 28202-0213
(248) 770-3658
Mailing address
311 BOULEVARD OF AMERICAS STE 109, LAKEWOOD, NJ 08701-4788
(248) 770-3658
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
01/14/2025
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