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General NPI Number Information
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NPI Number | 1053621953
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Entity Type | Organization
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Legal Business Name | 1987LLC D/B/A SYNERGY HOMECARE
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 108 E WHEEL RD SUITE 101
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City | BEL AIR
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State | MD
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Zip | 21015-8906
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Country | US
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Telephone | 410-569-3302
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Fax | 888-502-9093
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Provider Business Mailing Address
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Address Line | 108 E WHEEL RD SUITE 101
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City | BEL AIR
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State | MD
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Zip | 21015-8906
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Country | US
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Telephone | 410-569-3302
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Fax | 888-502-9093
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. MARK S DECKER
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Credential |
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Telephone | 410-569-3302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R3538
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License Number State | MD
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