Provider Demographics
NPI:1184097636
Name:PROFESSIONAL SLEEP SERVICES
Entity type:Organization
Organization Name:PROFESSIONAL SLEEP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROUNDS-MENARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-396-5923
Mailing Address - Street 1:191 TELLURIDE ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4356
Mailing Address - Country:US
Mailing Address - Phone:033-965-9233
Mailing Address - Fax:303-957-5414
Practice Address - Street 1:191 TELLURIDE ST UNIT 5
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4356
Practice Address - Country:US
Practice Address - Phone:303-396-5923
Practice Address - Fax:303-957-5414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty