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General NPI Number Information
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NPI Number | 1235017625
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Entity Type | Organization
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Legal Business Name | SYNERGY: COMPREHENSIVE CARE FOR MIND, HEART, AND HOME
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 636 N ST ANDREWS PL APT 1
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City | LOS ANGELES
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State | CA
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Zip | 90004-1778
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Country | US
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Telephone | 424-309-2641
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 291083
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City | LOS ANGELES
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State | CA
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Zip | 90029-9083
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Country | US
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Telephone | 424-309-2641
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Fax |
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Authorized Official
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Title or Position | CHIEF OF MORAL SUPPORT/FOUNDER
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Name | CARLOS VELASCO
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Credential | LPCC
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Telephone | 424-309-2641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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