Provider Demographics
NPI:1144414830
Name:SLEEPWELL PARTNER LLC
Entity Type:Organization
Organization Name:SLEEPWELL PARTNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAI
Authorized Official - Middle Name:
Authorized Official - Last Name:WENK-WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-863-0490
Mailing Address - Street 1:17780 FITCH
Mailing Address - Street 2:SUITE 240
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 SW OAK ST
Practice Address - Street 2:SUITE 350, 3RD FLOOR
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6583
Practice Address - Country:US
Practice Address - Phone:503-206-2682
Practice Address - Fax:949-936-2601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AVASTRAUSA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-05
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic