Provider Demographics
NPI:1144334319
Name:INSTITUTE OF SLEEP AND WELLNESS LLC
Entity type:Organization
Organization Name:INSTITUTE OF SLEEP AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-263-8144
Mailing Address - Street 1:15930 19 MILE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1155
Mailing Address - Country:US
Mailing Address - Phone:586-263-8144
Mailing Address - Fax:586-263-8155
Practice Address - Street 1:15930 19 MILE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1155
Practice Address - Country:US
Practice Address - Phone:586-263-8144
Practice Address - Fax:586-263-8155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144334319Medicaid
MI130E020940OtherBC GROUP
MIMI1735Medicare PIN
MI0P45650Medicare PIN
MI1144334319Medicaid