Provider Demographics
NPI:1316195035
Name:INLAND SLEEP CENTER, LLC
Entity Type:Organization
Organization Name:INLAND SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICAL SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, CRT
Authorized Official - Phone:208-699-9395
Mailing Address - Street 1:609 N CALGARY CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:609 N CALGARY CT
Practice Address - Street 2:SUITE 103
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4906
Practice Address - Country:US
Practice Address - Phone:208-699-9391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic