Provider Demographics
NPI:1265021091
Name:SPINELLI GROUP LLC
Entity Type:Organization
Organization Name:SPINELLI GROUP LLC
Other - Org Name:SYNERGY HOMECARE OF SHEBOYGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-783-6199
Mailing Address - Street 1:615 S 8TH ST STE 220E
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4463
Mailing Address - Country:US
Mailing Address - Phone:920-783-6199
Mailing Address - Fax:920-783-8198
Practice Address - Street 1:615 S 8TH ST STE 220E
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4463
Practice Address - Country:US
Practice Address - Phone:920-783-6199
Practice Address - Fax:920-783-8198
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGY HOMECARE OF SHEBOYGAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-15
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No347C00000XTransportation ServicesPrivate Vehicle