Provider Demographics
NPI:1063879112
Name:SYNERGY LIFE, INC.
Entity type:Organization
Organization Name:SYNERGY LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DASHEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-449-4069
Mailing Address - Street 1:182 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2830
Mailing Address - Country:US
Mailing Address - Phone:508-449-4069
Mailing Address - Fax:508-459-2478
Practice Address - Street 1:182 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2830
Practice Address - Country:US
Practice Address - Phone:508-449-4069
Practice Address - Fax:508-459-2478
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYSTATE VISION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health