Provider Demographics
NPI:1538349832
Name:SLEEP CENTERS OF AMERICA, LLC
Entity type:Organization
Organization Name:SLEEP CENTERS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:R
Authorized Official - Last Name:KLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-610-6761
Mailing Address - Street 1:G3255 BEECHER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3655
Mailing Address - Country:US
Mailing Address - Phone:810-230-6400
Mailing Address - Fax:810-230-6441
Practice Address - Street 1:G3255 BEECHER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3655
Practice Address - Country:US
Practice Address - Phone:810-230-6400
Practice Address - Fax:810-230-6441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QS1200X261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11-0-B5-1898-0OtherBCBSM
MIOP55710Medicare PIN