Provider Demographics
NPI:1912264102
Name:SLEEP WELLNESS INSTITUTE, INC
Entity Type:Organization
Organization Name:SLEEP WELLNESS INSTITUTE, INC
Other - Org Name:CPAP2GO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-336-3000
Mailing Address - Street 1:2356 S 102ND ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2104
Mailing Address - Country:US
Mailing Address - Phone:414-336-3000
Mailing Address - Fax:414-336-1015
Practice Address - Street 1:11725 N PORT WASHINGTON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3485
Practice Address - Country:US
Practice Address - Phone:414-336-3000
Practice Address - Fax:414-336-1015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP WELLNESS INSTITUTE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-12
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32890000Medicaid
1140390002Medicare NSC
WI32890000Medicaid