Provider Demographics
NPI:1366012189
Name:CMVSLEEP
Entity Type:Organization
Organization Name:CMVSLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:CHRISTOPHER (CHRIS)
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:575-644-2196
Mailing Address - Street 1:14228 LA CUEVA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1810
Mailing Address - Country:US
Mailing Address - Phone:575-644-2196
Mailing Address - Fax:
Practice Address - Street 1:14228 LA CUEVA AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1810
Practice Address - Country:US
Practice Address - Phone:575-644-2196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic