Provider Demographics
NPI:1023590908
Name:IBERIA SLEEP CENTER, LLC
Entity type:Organization
Organization Name:IBERIA SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, CCSH
Authorized Official - Phone:337-551-4471
Mailing Address - Street 1:715 N LEWIS ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2045
Mailing Address - Country:US
Mailing Address - Phone:337-551-4471
Mailing Address - Fax:337-551-4478
Practice Address - Street 1:715 N LEWIS ST STE B
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2045
Practice Address - Country:US
Practice Address - Phone:337-551-4471
Practice Address - Fax:337-551-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic