Provider Demographics
NPI:1396787032
Name:COMPREHENSIVE SLEEP SOLUTIONS, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE SLEEP SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-446-9010
Mailing Address - Street 1:PO BOX 40520
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-0520
Mailing Address - Country:US
Mailing Address - Phone:480-446-9010
Mailing Address - Fax:480-993-2033
Practice Address - Street 1:4045 E UNION HILLS DR
Practice Address - Street 2:STE 124
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3386
Practice Address - Country:US
Practice Address - Phone:602-569-1735
Practice Address - Fax:602-569-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 3871261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ093875Medicaid
AZ093875Medicaid