Provider Demographics
NPI:1326274861
Name:ADVANCED SLEEP ALTERNATIVES, LLC
Entity Type:Organization
Organization Name:ADVANCED SLEEP ALTERNATIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CREAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-460-6596
Mailing Address - Street 1:609 E SILVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-1972
Mailing Address - Country:US
Mailing Address - Phone:602-460-6596
Mailing Address - Fax:602-264-4231
Practice Address - Street 1:640 E 700 S
Practice Address - Street 2:SUITE 105-A
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4023
Practice Address - Country:US
Practice Address - Phone:435-767-0718
Practice Address - Fax:602-264-4231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP ALTERNATIVES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-10
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5117335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier