Healthcare Provider Details

I. General information

NPI: 1194802058
Provider Name (Legal Business Name): CONSOLIDATED SLEEP ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6265 W RIVER RD NE
BELMONT MI
49306-9078
US

IV. Provider business mailing address

6265 W RIVER RD NE
BELMONT MI
49306-9078
US

V. Phone/Fax

Practice location:
  • Phone: 616-363-8670
  • Fax: 616-363-8690
Mailing address:
  • Phone: 616-363-8670
  • Fax: 616-363-8690

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. EDWARD J ROGERS
Title or Position: OWNER
Credential:
Phone: 810-287-6787