1912193590 NPI number — SLEEP SOLUTIONS OF HOUMA LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912193590 NPI number — SLEEP SOLUTIONS OF HOUMA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP SOLUTIONS OF HOUMA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912193590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 699
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISONVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70447-0699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-875-7557
Provider Business Mailing Address Fax Number:
985-875-0595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
632 CORPORATE DRIVE
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
HOUMA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-223-8982
Provider Business Practice Location Address Fax Number:
985-223-6255
Provider Enumeration Date:
09/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JUNIUS
Authorized Official First Name:
JO
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BILLING & COLLECTIONS
Authorized Official Telephone Number:
985-875-7557

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)