| Organization Name: | CLAIRE BROOKE SLEEP CENTER LLC |
| NPI Number: | 1205234259 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY DAWN KOGER (OWNER) |
| Mailing Address: | 102 Greenland Dr Goose Creek |
| State: | SC US |
| Postal Code: | 294455353 |
| Phone Number: | 8432036551 |
| Fax Number: | 8432036552 |
| NPI Enumeration Date: | 12/08/2014 |
| NPI Last Update Date: | 12/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |