Provider Demographics
NPI:1942951348
Name:SYNERGISTIC BEHAVIORAL, LLC
Entity Type:Organization
Organization Name:SYNERGISTIC BEHAVIORAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GIGI
Authorized Official - Middle Name:
Authorized Official - Last Name:ACEVEDO-PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:888-210-2466
Mailing Address - Street 1:2245 TEXAS DRIVE
Mailing Address - Street 2:SUITE 300 PMB 300207
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:888-210-2466
Mailing Address - Fax:
Practice Address - Street 1:2245 TEXAS DR
Practice Address - Street 2:300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:888-210-2466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management