Provider Demographics
NPI:1356091532
Name:SYNGOZ LLC
Entity Type:Organization
Organization Name:SYNGOZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FORTUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:UBANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-861-5557
Mailing Address - Street 1:408 TEMPLE TRL
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3615
Mailing Address - Country:US
Mailing Address - Phone:214-861-5557
Mailing Address - Fax:
Practice Address - Street 1:408 TEMPLE TRL
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-3615
Practice Address - Country:US
Practice Address - Phone:214-861-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based