Provider Demographics
NPI:1962788505
Name:THE SHED, LLC
Entity type:Organization
Organization Name:THE SHED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLONDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-702-9192
Mailing Address - Street 1:305 ARIZONA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2207
Mailing Address - Country:US
Mailing Address - Phone:678-702-9192
Mailing Address - Fax:404-687-8468
Practice Address - Street 1:305 ARIZONA AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2207
Practice Address - Country:US
Practice Address - Phone:678-702-9192
Practice Address - Fax:404-687-8468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty