Provider Demographics
NPI:1295067049
Name:THE SLEEP CENTER, LLC
Entity type:Organization
Organization Name:THE SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-879-1938
Mailing Address - Street 1:10176 W. 400 NORTH
Mailing Address - Street 2:SUITE A
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9009
Mailing Address - Country:US
Mailing Address - Phone:219-879-1938
Mailing Address - Fax:219-879-1938
Practice Address - Street 1:10176 W. 400 NORTH
Practice Address - Street 2:SUITE B
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9009
Practice Address - Country:US
Practice Address - Phone:219-878-5864
Practice Address - Fax:219-878-0632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041335A291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory