Provider Demographics
NPI:1124363312
Name:KYNERGY HOME CARE
Entity Type:Organization
Organization Name:KYNERGY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-464-8017
Mailing Address - Street 1:4321 ANTIQUE LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1807
Mailing Address - Country:US
Mailing Address - Phone:248-432-7276
Mailing Address - Fax:248-254-6678
Practice Address - Street 1:4321 ANTIQUE LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1807
Practice Address - Country:US
Practice Address - Phone:248-432-7276
Practice Address - Fax:248-254-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health