Provider Demographics
NPI:1891166716
Name:TENNESSEE SLEEP MANAGEMENT OF BRENTWOOD
Entity Type:Organization
Organization Name:TENNESSEE SLEEP MANAGEMENT OF BRENTWOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:CRT-SDS
Authorized Official - Phone:731-413-8490
Mailing Address - Street 1:7103 BAKERS BRIDGE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2892
Mailing Address - Country:US
Mailing Address - Phone:615-732-5712
Mailing Address - Fax:615-634-8350
Practice Address - Street 1:7103 BAKERS BRIDGE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2892
Practice Address - Country:US
Practice Address - Phone:615-732-5712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD24304261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic