Provider Demographics
NPI:1225079171
Name:PLEASANT DREAMS SLEEP CENTER LLC
Entity Type:Organization
Organization Name:PLEASANT DREAMS SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:KILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-345-3408
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-0903
Mailing Address - Country:US
Mailing Address - Phone:989-345-2068
Mailing Address - Fax:989-345-5803
Practice Address - Street 1:1205 S MISSION ST
Practice Address - Street 2:SUITE 24
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3939
Practice Address - Country:US
Practice Address - Phone:989-775-0205
Practice Address - Fax:989-345-3514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010728712084N0400X
261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301072871OtherLICENSE
MI1134100175OtherNPI