Healthcare Provider Details

I. General information

NPI: 1023342953
Provider Name (Legal Business Name): THE SLEEP HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 5TH ST STE 240
RAPID CITY SD
57701-7338
US

IV. Provider business mailing address

2929 5TH ST STE 240
RAPID CITY SD
57701-7338
US

V. Phone/Fax

Practice location:
  • Phone: 605-342-5514
  • Fax: 605-721-6478
Mailing address:
  • Phone: 605-342-5514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier102533300
Identifier TypeMEDICAID
Identifier StateWY
Identifier Issuer
# 2
Identifier0000058
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerBC/BS

VIII. Authorized Official

Name: MANDY LEFOR
Title or Position: PATIENT ACCOUNTS
Credential:
Phone: 605-341-3770