Provider Demographics
NPI:1225169469
Name:SYNANON, INC. IN HOME CARE NURSING
Entity Type:Organization
Organization Name:SYNANON, INC. IN HOME CARE NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-846-2015
Mailing Address - Street 1:1500 S DESPELDER ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2632
Mailing Address - Country:US
Mailing Address - Phone:616-847-9090
Mailing Address - Fax:
Practice Address - Street 1:1500 S DESPELDER ST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2632
Practice Address - Country:US
Practice Address - Phone:616-847-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health