Provider Demographics
NPI:1699183343
Name:THE SLEEP WELLNESS INSTITUTE
Entity Type:Organization
Organization Name:THE SLEEP WELLNESS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-336-3000
Mailing Address - Street 1:1414 N TAYLOR DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1988
Mailing Address - Country:US
Mailing Address - Phone:414-336-3000
Mailing Address - Fax:414-336-1015
Practice Address - Street 1:2356 S 102ND ST
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2104
Practice Address - Country:US
Practice Address - Phone:414-336-3000
Practice Address - Fax:414-336-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431468174400000X
332B00000X
WIWI-112764363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty