Provider Demographics
NPI:1881927200
Name:SYNERGY SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:SYNERGY SUPPORT SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNICA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SCATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-641-6867
Mailing Address - Street 1:4914 B ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-6259
Mailing Address - Country:US
Mailing Address - Phone:202-641-6867
Mailing Address - Fax:
Practice Address - Street 1:4914 B ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6259
Practice Address - Country:US
Practice Address - Phone:202-641-6867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities