Healthcare Provider Details
I. General information
NPI: 1255685103
Provider Name (Legal Business Name): GOOD NIGHT SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10000 WAYNE RD SUITE # 107
ROMULUS MI
48174-3445
US
IV. Provider business mailing address
10000 WAYNE RD
ROMULUS MI
48174-3445
US
V. Phone/Fax
- Phone: 734-323-7776
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RHONDA
DOUGLAS
Title or Position: OWNER
Credential:
Phone: 734-323-7776