Provider Demographics
NPI:1417183237
Name:RESTORATIVE SLEEP, LLC
Entity Type:Organization
Organization Name:RESTORATIVE SLEEP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:LOOMIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-698-2654
Mailing Address - Street 1:201 N. MAYFAIR RD
Mailing Address - Street 2:STE 505
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-698-2654
Mailing Address - Fax:262-241-8894
Practice Address - Street 1:201 N. MAYFAIR RD
Practice Address - Street 2:STE 505
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-698-2654
Practice Address - Fax:262-241-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2083-057261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center