Provider Demographics
NPI:1366759862
Name:SYNERGY HOMECARE OF SOUTH DAYTON
Entity type:Organization
Organization Name:SYNERGY HOMECARE OF SOUTH DAYTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-610-0555
Mailing Address - Street 1:535 WINDSOR PARK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4112
Mailing Address - Country:US
Mailing Address - Phone:937-610-0555
Mailing Address - Fax:
Practice Address - Street 1:535 WINDSOR PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4112
Practice Address - Country:US
Practice Address - Phone:937-610-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care