Healthcare Provider Details

I. General information

NPI: 1861731663
Provider Name (Legal Business Name): RELIANCE SLEEP CENTERS OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 YEOMANS ST
BLACKSHEAR GA
31516-2083
US

IV. Provider business mailing address

87 LINDSEY LANE UNIT A
KINGSLAND GA
31548-6836
US

V. Phone/Fax

Practice location:
  • Phone: 912-807-0904
  • Fax: 912-807-0904
Mailing address:
  • Phone: 912-576-6831
  • Fax: 912-576-6861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE SHEHEE
Title or Position: CEO
Credential: RPSGT, RST
Phone: 912-388-4556