Provider Demographics
NPI:1124185350
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:480-993-2033
Practice Address - Street 1:12725 W INDIAN SCHOOL RD
Practice Address - Street 2:F-102
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-9520
Practice Address - Country:US
Practice Address - Phone:623-935-2226
Practice Address - Fax:623-935-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ118104OtherMEDICARE B PROVIDER #
AZ209630Medicaid