Healthcare Provider Details

I. General information

NPI: 1508948969
Provider Name (Legal Business Name): SLEEP INSTITUTE OF UTAH LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552 E 1400 S
OREM UT
84097-7714
US

IV. Provider business mailing address

1323 W SOUTH JORDAN PKWY STE 101
SOUTH JORDAN UT
84095-9060
US

V. Phone/Fax

Practice location:
  • Phone: 801-437-4891
  • Fax: 801-437-4892
Mailing address:
  • Phone: 801-254-2895
  • Fax: 801-254-4715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateUT

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. JEANETTE D ROBINS
Title or Position: MEMBER MANAGER
Credential: RPSGT
Phone: 801-254-2895