Provider Demographics
NPI:1336506021
Name:THE SLEEP WELLNESS INSTITUTE INC
Entity Type:Organization
Organization Name:THE SLEEP WELLNESS INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-336-3000
Mailing Address - Street 1:2356 S 102ND ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2104
Mailing Address - Country:US
Mailing Address - Phone:414-328-5643
Mailing Address - Fax:414-336-1015
Practice Address - Street 1:13133 N PORT WASHINGTON RD
Practice Address - Street 2:STE 104
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-2419
Practice Address - Country:US
Practice Address - Phone:262-243-5044
Practice Address - Fax:262-243-2510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SLEEP WELLNESS INSTITUTE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment