Healthcare Provider Details
I. General information
NPI: 1477584688
Provider Name (Legal Business Name): LIFE CARE SLEEP AND HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/05/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7200 W SAGINAW HWY STE 2
LANSING MI
48917-1133
US
IV. Provider business mailing address
7200 W SAGINAW HWY STE 2
LANSING MI
48917-1133
US
V. Phone/Fax
- Phone: 517-323-9624
- Fax: 517-323-9634
- Phone: 517-323-9624
- Fax: 517-323-9634
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
GAUCKEL
Title or Position: CEO
Credential:
Phone: 517-323-9624