Provider Demographics
NPI:1134428972
Name:INTERNATIONAL INSTITUTE OF SLEEP OF LAS VEGAS, INC.
Entity type:Organization
Organization Name:INTERNATIONAL INSTITUTE OF SLEEP OF LAS VEGAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-481-3870
Mailing Address - Street 1:2151 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1200
Mailing Address - Country:US
Mailing Address - Phone:800-481-3870
Mailing Address - Fax:800-481-3859
Practice Address - Street 1:4275 S BURNHAM AVENUE
Practice Address - Street 2:SUITE 355
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:800-481-3870
Practice Address - Fax:800-481-3859
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNATIONAL INSTITUTE OF SLEEP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies