MEDICARE: SYNERGY HOME CARE NORTHWESTERN REGION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	910	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982696217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY HOME CARE NORTHWESTERN REGION INC

Provider Business Mailing Address
First Line	:	6330 SPRINT PKWY STE 300
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 RUSH ST
Second Line	:
City	:	COUSHATTA
State	:	LA
Zip	:	71019-9255
Country	:	US
Telephone Number	:	318-932-4442
Fax Number	:	318-932-4404

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	JOHN NICHOLS
Credential	:
Telephone Number	:	318-932-4442

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	11/30/2023

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