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General NPI Number Information
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NPI Number | 1881927200
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Entity Type | Organization
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Legal Business Name | SYNERGY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 4914 B ST SE
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City | WASHINGTON
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State | DC
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Zip | 20019-6259
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Country | US
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Telephone | 202-641-6867
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Fax |
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Provider Business Mailing Address
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Address Line | 4914 B ST SE
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City | WASHINGTON
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State | DC
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Zip | 20019-6259
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Country | US
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Telephone | 202-641-6867
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DONNICA DANIELLE SCATES
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Credential |
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Telephone | 202-641-6867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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