Provider Demographics
NPI:1063739324
Name:HEALTHY HEART SLEEP CENTER, LLC
Entity type:Organization
Organization Name:HEALTHY HEART SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HINKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-641-9161
Mailing Address - Street 1:1830 TOWN CENTER DR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3292
Mailing Address - Country:US
Mailing Address - Phone:703-481-3165
Mailing Address - Fax:703-481-6228
Practice Address - Street 1:1830 TOWN CENTER DR
Practice Address - Street 2:SUITE 405
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3292
Practice Address - Country:US
Practice Address - Phone:703-481-3165
Practice Address - Fax:703-481-6228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory