Healthcare Provider Details

I. General information

NPI: 1619417136
Provider Name (Legal Business Name): MELIOREM SLEEP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4828 SPARKS BLVD
SPARKS NV
89436-8120
US

IV. Provider business mailing address

4828 SPARKS BLVD
SPARKS NV
89436-8120
US

V. Phone/Fax

Practice location:
  • Phone: 775-557-4900
  • Fax: 775-557-7240
Mailing address:
  • Phone: 775-557-4900
  • Fax: 775-557-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number16000
License Number StateNV

VIII. Authorized Official

Name: DR. INNOCENT C EZENWA
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 755-557-4900