Provider Demographics
NPI:1679290647
Name:SLEEP TIGHT TALLAHASSEE LLC
Entity Type:Organization
Organization Name:SLEEP TIGHT TALLAHASSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ECKLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:850-322-5320
Mailing Address - Street 1:3605 LONGFORD DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3250
Mailing Address - Country:US
Mailing Address - Phone:850-322-5320
Mailing Address - Fax:
Practice Address - Street 1:3620 SHAMROCK W
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-2642
Practice Address - Country:US
Practice Address - Phone:850-987-5337
Practice Address - Fax:850-848-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty