Healthcare Provider Details

I. General information

NPI: 1427436930
Provider Name (Legal Business Name): BROOKS HOME SLEEP STUDIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2015
Last Update Date: 05/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKS HOME SLEEP STUDIES LLC ULM, STUBBS HALL 203, 700 UNIVERSITY AVENUE
MONROE LA
71209-6435
US

IV. Provider business mailing address

BROOKS HOME SLEEP STUDIES LLC ULM, STUBBS HALL 203, 700 UNIVERSITY AVENUE
MONROE LA
71209-6435
US

V. Phone/Fax

Practice location:
  • Phone: 318-342-1442
  • Fax: 318-625-0605
Mailing address:
  • Phone: 318-342-1442
  • Fax: 318-625-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number203139
License Number StateLA

VIII. Authorized Official

Name: MRS. MELISSA BYNES BROOKS
Title or Position: OWNER/ PRESIDENT
Credential: MBA, RPSGT, CRT
Phone: 318-237-9776