Provider Demographics
NPI:1083097653
Name:HOME SLEEP SPECTRUMS
Entity Type:Organization
Organization Name:HOME SLEEP SPECTRUMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MOUCHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:575-373-8415
Mailing Address - Street 1:2801 MISSOURI AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5075
Mailing Address - Country:US
Mailing Address - Phone:575-373-8415
Mailing Address - Fax:
Practice Address - Street 1:2801 MISSOURI AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5075
Practice Address - Country:US
Practice Address - Phone:575-373-8415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR44376261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic