Provider Demographics
NPI:1831315407
Name:WELCOME HOMECARE SLEEP DISORDER CLINICS INC
Entity Type:Organization
Organization Name:WELCOME HOMECARE SLEEP DISORDER CLINICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHOUVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-421-3944
Mailing Address - Street 1:9570 REGENCY SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-8100
Mailing Address - Country:US
Mailing Address - Phone:904-421-3970
Mailing Address - Fax:904-421-3908
Practice Address - Street 1:9570 REGENCY SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-8100
Practice Address - Country:US
Practice Address - Phone:904-421-3970
Practice Address - Fax:904-421-3908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6490261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC6490Medicare ID - Type UnspecifiedSLEEP CENTER