Provider Demographics
NPI:1083701601
Name:SLEEP INSTITUTE OF UTAH LLC
Entity Type:Organization
Organization Name:SLEEP INSTITUTE OF UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ROBINS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:801-254-2895
Mailing Address - Street 1:8706 S 700 E
Mailing Address - Street 2:STE 027
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-1807
Mailing Address - Country:US
Mailing Address - Phone:801-254-2895
Mailing Address - Fax:801-254-4715
Practice Address - Street 1:1464 E RIDGELINE DR
Practice Address - Street 2:STE 104
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4998
Practice Address - Country:US
Practice Address - Phone:801-254-2895
Practice Address - Fax:801-254-4715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP INSTITUTE OF UTAH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-06
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic