Healthcare Provider Details

I. General information

NPI: 1285316620
Provider Name (Legal Business Name): REMAGINE SLEEP CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 08/04/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22190 GARRISON ST STE 101
DEARBORN MI
48124-2260
US

IV. Provider business mailing address

22190 GARRISON ST STE 101
DEARBORN MI
48124-2260
US

V. Phone/Fax

Practice location:
  • Phone: 313-444-9989
  • Fax: 313-444-9986
Mailing address:
  • Phone: 313-444-9989
  • Fax: 313-444-9986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: HUSSINE HIDER
Title or Position: OWNER
Credential:
Phone: 313-444-9989