Provider Demographics
NPI:1962735001
Name:SYNERGY HOME HEALTH SYSTEM
Entity type:Organization
Organization Name:SYNERGY HOME HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-481-9417
Mailing Address - Street 1:2550 TELEGRAPH RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:248-481-9417
Mailing Address - Fax:248-481-9578
Practice Address - Street 1:2550 TELEGRAPH RD
Practice Address - Street 2:SUITE 114
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302
Practice Address - Country:US
Practice Address - Phone:248-481-9417
Practice Address - Fax:248-481-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
239168Medicare Oscar/Certification