Healthcare Provider Details

I. General information

NPI: 1821477027
Provider Name (Legal Business Name): ADVANCED SLEEP CARE CENTERS OF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6979 S HOLLY CIR STE 185
CENTENNIAL CO
80112-1065
US

IV. Provider business mailing address

6979 S HOLLY CIR STE 185
CENTENNIAL CO
80112-1065
US

V. Phone/Fax

Practice location:
  • Phone: 720-457-1110
  • Fax: 303-773-3726
Mailing address:
  • Phone: 720-457-1110
  • Fax: 303-773-3726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JANE MARIE PRENDERGAST
Title or Position: SOLE MBR
Credential:
Phone: 720-457-1110