Provider Demographics
NPI:1700057700
Name:SLEEP COLORADO AURORA CAMPUS
Entity type:Organization
Organization Name:SLEEP COLORADO AURORA CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-492-4574
Mailing Address - Street 1:2660 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-4033
Mailing Address - Country:US
Mailing Address - Phone:719-492-4574
Mailing Address - Fax:
Practice Address - Street 1:14991 E. HAMPDEN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3983
Practice Address - Country:US
Practice Address - Phone:303-395-5548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO SLEEP COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-18
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic