Provider Demographics
NPI:1407089428
Name:SYNERGY REHAB SERVICES INC.
Entity Type:Organization
Organization Name:SYNERGY REHAB SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MANGIO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:650-283-2087
Mailing Address - Street 1:1580 SOUTHGATE AVE
Mailing Address - Street 2:#420
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2262
Mailing Address - Country:US
Mailing Address - Phone:650-283-2087
Mailing Address - Fax:650-991-3658
Practice Address - Street 1:1580 SOUTHGATE AVE
Practice Address - Street 2:#420
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2262
Practice Address - Country:US
Practice Address - Phone:650-283-2087
Practice Address - Fax:650-991-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8458225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty