Provider Demographics
NPI:1649625187
Name:MOUNTAIN SLEEP DIAGNOSTICS, INC
Entity type:Organization
Organization Name:MOUNTAIN SLEEP DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE AND OPERATIONS DIRECTOR
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
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4355
Mailing Address - Country:US
Mailing Address - Phone:303-396-5923
Mailing Address - Fax:303-957-5414
Practice Address - Street 1:191 TELLURIDE ST UNIT 6
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNTAIN SLEEP DIAGNOSTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-03
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic