Provider Demographics
NPI:1114314564
Name:INNOVATIVE SLEEP SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE SLEEP SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:LRPSGT
Authorized Official - Phone:337-342-2045
Mailing Address - Street 1:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-1122
Mailing Address - Country:US
Mailing Address - Phone:337-342-2045
Mailing Address - Fax:337-342-2045
Practice Address - Street 1:507 PORTER ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-3442
Practice Address - Country:US
Practice Address - Phone:337-441-0478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPOLY000271246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty