Provider Demographics
NPI:1821180795
Name:SLEEP SUCCESS TECHNOLOGY, INC.
Entity Type:Organization
Organization Name:SLEEP SUCCESS TECHNOLOGY, INC.
Other - Org Name:SOUTHEAST NEUROLOGY & SLEEP DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-752-3295
Mailing Address - Street 1:PO BOX 78536
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28271-7036
Mailing Address - Country:US
Mailing Address - Phone:704-752-3295
Mailing Address - Fax:704-752-3296
Practice Address - Street 1:15830 JOHN J DELANEY DR
Practice Address - Street 2:SUITE 125
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3294
Practice Address - Country:US
Practice Address - Phone:704-752-3295
Practice Address - Fax:704-752-3296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QM1300X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Not Answered261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903469Medicaid