Healthcare Provider Details
I. General information
NPI: 1417707027
Provider Name (Legal Business Name): INTELLIX HEALTH & NURSING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2024
Last Update Date: 03/26/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13132 STUDEBAKER RD STE 310
NORWALK CA
90650-2557
US
IV. Provider business mailing address
24325 CRENSHAW BLVD # 267
TORRANCE CA
90505-5349
US
V. Phone/Fax
- Phone: 562-519-6647
- Fax:
- Phone: 562-519-6647
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMAKA
ANYAOHA
Title or Position: PSYCH NP/FNP
Credential: DNP
Phone: 562-519-6647