Healthcare Provider Details
I. General information
NPI: 1346064490
Provider Name (Legal Business Name): HEALTHY SLEEP MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2024
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5777 W MAPLE RD STE 185
WEST BLOOMFIELD MI
48322-2268
US
IV. Provider business mailing address
5777 W MAPLE RD STE 185
WEST BLOOMFIELD MI
48322-2268
US
V. Phone/Fax
- Phone: 248-688-0088
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNA
KADO
Title or Position: OWNER
Credential: MD
Phone: 248-688-0088