Provider Demographics
NPI:1215176177
Name:MAUMELLE SLEEP SOLUTIONS, LLC
Entity type:Organization
Organization Name:MAUMELLE SLEEP SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENKE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT,RPSGT
Authorized Official - Phone:501-224-5200
Mailing Address - Street 1:9305 TREASURE HILL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-6217
Mailing Address - Country:US
Mailing Address - Phone:501-224-5200
Mailing Address - Fax:501-224-5208
Practice Address - Street 1:501 MILLWOOD CIR
Practice Address - Street 2:SUITE F
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6327
Practice Address - Country:US
Practice Address - Phone:501-224-5200
Practice Address - Fax:501-224-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic