Provider Demographics
NPI:1942746839
Name:SYNERGY TRANSPORTATION SERVICE LLC
Entity Type:Organization
Organization Name:SYNERGY TRANSPORTATION SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHADISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS-DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:313-784-5560
Mailing Address - Street 1:29155 NORTHWESTERN HWY UNIT 781
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1011
Mailing Address - Country:US
Mailing Address - Phone:313-784-5560
Mailing Address - Fax:
Practice Address - Street 1:14954 MEYERS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-4088
Practice Address - Country:US
Practice Address - Phone:313-784-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)