Provider Demographics
NPI:1043360365
Name:C & C SLEEP DIAGNOSTICS , LLC
Entity Type:Organization
Organization Name:C & C SLEEP DIAGNOSTICS , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEDEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAMPINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-230-0120
Mailing Address - Street 1:811 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1360
Mailing Address - Country:US
Mailing Address - Phone:810-230-0120
Mailing Address - Fax:
Practice Address - Street 1:811 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1360
Practice Address - Country:US
Practice Address - Phone:810-230-0120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID
MI=========OtherTAX ID