Provider Demographics
NPI:1962069005
Name:SUPERIOR SLEEP AND WELLNESS OF CONEJO VALLEY LLC
Entity type:Organization
Organization Name:SUPERIOR SLEEP AND WELLNESS OF CONEJO VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLECEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-912-7616
Mailing Address - Street 1:2510 S ROCHESTER RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1240 S WESTLAKE BLVD STE 131
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1932
Practice Address - Country:US
Practice Address - Phone:818-889-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty