Healthcare Provider Details

I. General information

NPI: 1649001892
Provider Name (Legal Business Name): BMH DEVELOPMENT INC. DBA: SYNERGY HOMECARE OF PORTLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9880 SW BEAVERTON HILLSDALE HWY STE 103
BEAVERTON OR
97005-3367
US

IV. Provider business mailing address

9880 SW BEAVERTON HILLSDALE HWY STE 103
BEAVERTON OR
97005-3367
US

V. Phone/Fax

Practice location:
  • Phone: 35-303-8388
  • Fax: 503-914-0444
Mailing address:
  • Phone: 503-303-8388
  • Fax: 503-914-0444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MALINDA LUTON
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 503-303-8388