Healthcare Provider Details

I. General information

NPI: 1679515316
Provider Name (Legal Business Name): COMPREHENSIVE SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 N TREKELL RD STE 101
CASA GRANDE AZ
85222-2215
US

IV. Provider business mailing address

PO BOX 40520
MESA AZ
85274-0520
US

V. Phone/Fax

Practice location:
  • Phone: 520-426-1480
  • Fax: 520-426-1487
Mailing address:
  • Phone: 480-446-9010
  • Fax: 480-993-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberOTC-3753
License Number StateAZ

VIII. Authorized Official

Name: JOHN BENN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 480-446-9010