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General NPI Number Information
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NPI Number | 1205019387
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Entity Type | Organization
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Legal Business Name | SOMNOLIFE, LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 1260 HIGHWAY 54 W SUITE 203
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4514
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Country | US
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Telephone | 770-692-7580
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Fax | 770-692-7584
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Provider Business Mailing Address
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Address Line | 1260 HIGHWAY 54 W SUITE 203
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4514
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Country | US
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Telephone | 770-692-7580
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Fax | 770-692-7584
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. JEFFREY SCOTT SANDERS
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Credential | MA
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Telephone | 678-521-0194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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