Provider Demographics
NPI:1700013786
Name:SLEEP SYNERGIES, LLC
Entity Type:Organization
Organization Name:SLEEP SYNERGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CREAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-460-6596
Mailing Address - Street 1:609 E SILVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-1972
Mailing Address - Country:US
Mailing Address - Phone:602-460-6596
Mailing Address - Fax:602-264-4231
Practice Address - Street 1:1678 OAKLAWN DR
Practice Address - Street 2:SUITE C-2
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1109
Practice Address - Country:US
Practice Address - Phone:928-443-7609
Practice Address - Fax:602-264-4231
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP ALTERNATIVES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-17
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5117335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6452530001Medicare NSC