Healthcare Provider Details

I. General information

NPI: 1821090044
Provider Name (Legal Business Name): COMPREHENSIVE SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 S COUNTRY CLUB WAY STE 112
TEMPE AZ
85282-4065
US

IV. Provider business mailing address

PO BOX 40520
MESA AZ
85274-0520
US

V. Phone/Fax

Practice location:
  • Phone: 480-603-0615
  • Fax: 480-603-0620
Mailing address:
  • Phone: 480-446-9010
  • Fax: 480-993-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberOTC 3333
License Number StateAZ

VIII. Authorized Official

Name: TERI LYNN JAMISON
Title or Position: GOVERNMENT COMPLIANCE MANAGER
Credential:
Phone: 480-446-9010