Healthcare Provider Details

I. General information

NPI: 1164132353
Provider Name (Legal Business Name): SLEEP & RESCUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9840 S 168TH AVE STE 4
OMAHA NE
68136-1102
US

IV. Provider business mailing address

9840 S 168TH AVE STE 4
OMAHA NE
68136-1102
US

V. Phone/Fax

Practice location:
  • Phone: 402-884-2400
  • Fax: 402-884-8788
Mailing address:
  • Phone: 402-884-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: KENDRA GOSCH
Title or Position: OWNER
Credential: DDS
Phone: 402-884-2400