Healthcare Provider Details

I. General information

NPI: 1184021990
Provider Name (Legal Business Name): PROSLEEP CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 UNION LAKE RD SUITE B
COMMERCE TOWNSHIP MI
48382-3590
US

IV. Provider business mailing address

2669 UNION LAKE RD SUITE B
COMMERCE TOWNSHIP MI
48382-3590
US

V. Phone/Fax

Practice location:
  • Phone: 248-956-0900
  • Fax:
Mailing address:
  • Phone: 248-956-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILSON JAMES
Title or Position: SP
Credential:
Phone: 248-956-0900