Provider Demographics
NPI:1659572907
Name:DREAM AWAY SLEEP LAB
Entity Type:Organization
Organization Name:DREAM AWAY SLEEP LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-790-9401
Mailing Address - Street 1:3326 ASPEN GROVE DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2837
Mailing Address - Country:US
Mailing Address - Phone:615-790-9401
Mailing Address - Fax:615-790-8688
Practice Address - Street 1:3326 ASPEN GROVE DR
Practice Address - Street 2:SUITE 260
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2837
Practice Address - Country:US
Practice Address - Phone:615-790-9401
Practice Address - Fax:615-790-8688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF53792Medicare UPIN
TN3790720Medicare ID - Type Unspecified