Provider Demographics
NPI:1457775264
Name:SYNERGY PRIVATE DUTY AND STAFFING
Entity Type:Organization
Organization Name:SYNERGY PRIVATE DUTY AND STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-662-6406
Mailing Address - Street 1:14954 MEYERS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-4088
Mailing Address - Country:US
Mailing Address - Phone:248-662-6406
Mailing Address - Fax:313-626-9207
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:248-662-6406
Practice Address - Fax:313-626-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIT656098051922251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI145775264Medicaid
MI145775264Medicare PIN