Provider Demographics
NPI:1144642083
Name:CEDAR VALLEY SLEEP CENTER
Entity type:Organization
Organization Name:CEDAR VALLEY SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:319-530-3168
Mailing Address - Street 1:2413 W RIDGEWAY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-4306
Mailing Address - Country:US
Mailing Address - Phone:319-505-2896
Mailing Address - Fax:319-505-2898
Practice Address - Street 1:2413 W RIDGEWAY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4306
Practice Address - Country:US
Practice Address - Phone:319-505-2896
Practice Address - Fax:319-505-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic