Provider Demographics
NPI:1073016689
Name:PROFESSIONAL SLEEP SERVICES
Entity Type:Organization
Organization Name:PROFESSIONAL SLEEP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-396-5923
Mailing Address - Street 1:191 TELLURIDE ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4356
Mailing Address - Country:US
Mailing Address - Phone:303-396-5923
Mailing Address - Fax:
Practice Address - Street 1:821 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-2445
Practice Address - Country:US
Practice Address - Phone:303-396-5923
Practice Address - Fax:303-957-5414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL SLEEP SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-10
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty