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General NPI Number Information
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NPI Number | 1881955417
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Entity Type | Organization
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Legal Business Name | SYNERGY HEALTH CARE SERVICES INC.
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 6297 ROBINS TRCE
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-6537
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Country | US
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Telephone | 770-413-1462
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Fax |
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Provider Business Mailing Address
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Address Line | 6297 ROBINS TRCE
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-6537
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Country | US
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Telephone | 770-413-1462
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. EMMANUEL DAFIVBIRORO
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Credential |
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Telephone | 770-413-1462
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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 | 044-R-0828
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License Number State | GA
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