Provider Demographics
NPI:1750663035
Name:QUALITY SLEEP SERVICES
Entity Type:Organization
Organization Name:QUALITY SLEEP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PH.D. RPSGT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLONDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-702-9192
Mailing Address - Street 1:829 PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6757
Mailing Address - Country:US
Mailing Address - Phone:678-702-9192
Mailing Address - Fax:404-687-8468
Practice Address - Street 1:829 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6757
Practice Address - Country:US
Practice Address - Phone:678-702-9192
Practice Address - Fax:404-687-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041296173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG81386Medicare UPIN