Basic Information
| Provider Information | |||||||||
| NPI: | 1013475292 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VALLEY SLEEP THERAPY INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | VALLEY SLEEP THERAPY | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 30388 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852750388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803610124 | ||||||||
| FaxNumber: | 4802475370 | ||||||||
| Practice Location | |||||||||
| Address1: | 6320 W UNION HILLS DR STE 1100B | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853081009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803610124 | ||||||||
| FaxNumber: | 4802475370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2019 | ||||||||
| LastUpdateDate: | 08/25/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| AuthorizedOfficialLastName: | LEADLEY | ||||||||
| AuthorizedOfficialFirstName: | LAURI | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO & PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6023009158 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CCSH, RPSGT | ||||||||
| NPICertificationDate: | 08/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.