Provider Demographics
NPI:1073558938
Name:COMPREHENSIVE SLEEP SOLUTIONS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE SLEEP SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-446-9010
Mailing Address - Street 1:PO BOX 40520
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-0520
Mailing Address - Country:US
Mailing Address - Phone:480-446-9010
Mailing Address - Fax:480-993-2087
Practice Address - Street 1:5671 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2211
Practice Address - Country:US
Practice Address - Phone:520-885-4699
Practice Address - Fax:520-885-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 3331261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ833609Medicaid
AZ71419Medicare ID - Type UnspecifiedMEDICARE PROVIDER #