Provider Demographics
NPI:1184084527
Name:SYNERGY EMPOWERMENT CENTER
Entity type:Organization
Organization Name:SYNERGY EMPOWERMENT CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-339-5668
Mailing Address - Street 1:928 S VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4416
Mailing Address - Country:US
Mailing Address - Phone:504-339-5668
Mailing Address - Fax:
Practice Address - Street 1:928 S VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-4416
Practice Address - Country:US
Practice Address - Phone:504-339-5668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-27
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No347C00000XTransportation ServicesPrivate Vehicle