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General NPI Number Information
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NPI Number | 1194490391
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Entity Type | Organization
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Legal Business Name | SYNERGY SATURDAY, INC.
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 400 PRESIDENT CLINTON AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72201-1638
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Country | US
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Telephone | 877-647-8648
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Fax | 870-888-0562
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Provider Business Mailing Address
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Address Line | PO BOX 26333
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City | LITTLE ROCK
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State | AR
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Zip | 72221-6333
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Country | US
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Telephone | 877-647-8648
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Fax | 870-888-0562
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | LARRY FREEMAN
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Credential |
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Telephone | 877-647-8648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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