=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366331530
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SYNGENEIA SOLUTIONS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2025
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 780 ELKRIDGE LANDING RD
-----------------------------------------------------
City | LINTHICUM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21090-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-360-1771
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 604 SHIRLEY MANOR RD
-----------------------------------------------------
City | REISTERSTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21136-2319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-360-1771
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. JAMODD BRYANT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 201-360-1771
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------