Provider Demographics
NPI:1891434213
Name:SYNERGY LIFESTYLE LIVING ASSISTANCE AGENCY LLC
Entity Type:Organization
Organization Name:SYNERGY LIFESTYLE LIVING ASSISTANCE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-367-5933
Mailing Address - Street 1:1200 E HIGH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-4954
Mailing Address - Country:US
Mailing Address - Phone:484-367-5933
Mailing Address - Fax:
Practice Address - Street 1:1200 E HIGH ST STE 201
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-4954
Practice Address - Country:US
Practice Address - Phone:484-367-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care