Provider Demographics
NPI:1881955417
Name:SYNERGY HEALTH CARE SERVICES INC.
Entity type:Organization
Organization Name:SYNERGY HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAFIVBIRORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-413-1462
Mailing Address - Street 1:6297 ROBINS TRCE
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6537
Mailing Address - Country:US
Mailing Address - Phone:770-413-1462
Mailing Address - Fax:
Practice Address - Street 1:6297 ROBINS TRCE
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-6537
Practice Address - Country:US
Practice Address - Phone:770-413-1462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-0828251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health