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NPI Code Detail

MEDICARE: SLEEP SOLUTIONS OF MANDEVILLE, LLC

MEDICARE: SLEEP SOLUTIONS OF MANDEVILLE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QS1200XSleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number : 1518298355
Entity Type Code : Organization
Provider Name (Legal Business Name) : SLEEP SOLUTIONS OF MANDEVILLE, LLC
Provider Business Mailing Address
First Line : PO BOX 699
Second Line :
City : MADISONVILLE
State : LA
Zip : 70447-0699
Country : US
Telephone Number : 985-875-7557
Fax Number : 985-875-0595
Provider Business Practice Location Address
First Line : 190 GREENBRIAR BLVD
Second Line : SUITE 101
City : COVINGTON
State : LA
Zip : 70433-7237
Country : US
Telephone Number : 985-875-7557
Fax Number : 985-875-0595
Authorized Official
Title or Position : MANAGER
Name : THOMAS E. LAVIN
Credential : MD
Telephone Number : 985-875-7557
Provider Enumeration Date : 01/19/2010
Last Update Date : 01/19/2010

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Directions to “SLEEP SOLUTIONS OF MANDEVILLE, LLC ” Practice Location

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