Provider Demographics
NPI:1568745727
Name:WILBUR SLEEPING CENTER INC
Entity Type:Organization
Organization Name:WILBUR SLEEPING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:POURMOUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-996-9188
Mailing Address - Street 1:18905 SHERMAN WAY
Mailing Address - Street 2:200
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2600
Mailing Address - Country:US
Mailing Address - Phone:818-996-9188
Mailing Address - Fax:818-966-9484
Practice Address - Street 1:18905 SHERMAN WAY
Practice Address - Street 2:200
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2600
Practice Address - Country:US
Practice Address - Phone:818-966-9188
Practice Address - Fax:818-966-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic