Healthcare Provider Details

I. General information

NPI: 1346870144
Provider Name (Legal Business Name): SLEEP BETTER IDAHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 N LESLIE WAY # 100
MERIDIAN ID
83646-5362
US

IV. Provider business mailing address

3200 N LESLIE WAY # 100
MERIDIAN ID
83646-5362
US

V. Phone/Fax

Practice location:
  • Phone: 208-412-1773
  • Fax: 888-388-0608
Mailing address:
  • Phone: 208-412-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KENYON OYLER
Title or Position: OWNER
Credential:
Phone: 208-412-1773