Organization Name: | ADVANCED SLEEP LABS, LLC |
NPI Number: | 1174568471 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TED NAMAN (CHIEF MEDICAL OFFICER) |
Mailing Address: | 1220 E 9 Mile Rd Suite 200 Ferndale |
State: | MI US |
Postal Code: | 482201972 |
Phone Number: | 2484142374 |
Fax Number: | 8887340534 |
NPI Enumeration Date: | 06/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | D0078W |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |