Provider Demographics
NPI:1285090068
Name:NORTH EAST CINCINNATI SLEEP SOLUTIONS LLC
Entity type:Organization
Organization Name:NORTH EAST CINCINNATI SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DRAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLLEFSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-712-7000
Mailing Address - Street 1:1120 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7612
Mailing Address - Country:US
Mailing Address - Phone:513-712-7000
Mailing Address - Fax:
Practice Address - Street 1:1120 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7612
Practice Address - Country:US
Practice Address - Phone:513-712-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic