Organization Name: | COCHISE SLEEP CENTER LLC |
NPI Number: | 1073565156 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIHAD GEORGES YOUSSEF (SOLE MEMBER) |
Mailing Address: | 2700 E Fry Blvd Bldg 2 Suite C2 Sierra Vista |
State: | AZ US |
Postal Code: | 856352826 |
Phone Number: | 5204398300 |
Fax Number: | 5204398303 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 12/14/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |