Provider Demographics
NPI:1497784201
Name:SLEEP DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTICS INC.
Other - Org Name:QUALITY SLEEP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PROCELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:318-861-7533
Mailing Address - Street 1:2800 YOUREE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3661
Mailing Address - Country:US
Mailing Address - Phone:318-861-7533
Mailing Address - Fax:318-861-7534
Practice Address - Street 1:2800 YOUREE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-3661
Practice Address - Country:US
Practice Address - Phone:318-861-7533
Practice Address - Fax:318-861-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAN/A261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CE48Medicare ID - Type UnspecifiedIDTF: PATICIPATING PROVID