Healthcare Provider Details
I. General information
NPI: 1346550605
Provider Name (Legal Business Name): SOUND SLEEP CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13770 FRONTIER CT SUITE 200
BURNSVILLE MN
55337-4810
US
IV. Provider business mailing address
12000 ELM CREEK BLVD N SUITE 360
MAPLE GROVE MN
55369-7073
US
V. Phone/Fax
- Phone: 952-997-2889
- Fax: 952-997-2937
- Phone: 763-315-4300
- Fax: 763-657-0077
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | 6586527 |
| License Number State | MN |
VIII. Authorized Official
Name: MS.
SHERI
ERICKSON
Title or Position: PRESIDENT
Credential:
Phone: 763-315-4300