Provider Demographics
NPI:1417018383
Name:SYNERGY HOMECARE MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:SYNERGY HOMECARE MANAGEMENT CORPORATION
Other - Org Name:ASSOCIATES HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:I
Authorized Official - Last Name:ODIGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-541-8707
Mailing Address - Street 1:1550 NE LOOP 410 STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1626
Mailing Address - Country:US
Mailing Address - Phone:210-541-8707
Mailing Address - Fax:210-541-8777
Practice Address - Street 1:1550 NE LOOP 410 STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1626
Practice Address - Country:US
Practice Address - Phone:210-541-8707
Practice Address - Fax:210-541-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008652251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1686867-01Medicaid
TX453158Medicare Oscar/Certification
TX453158Medicare PIN