Provider Demographics
NPI:1861731663
Name:RELIANCE SLEEP CENTERS OF AMERICA INC
Entity type:Organization
Organization Name:RELIANCE SLEEP CENTERS OF AMERICA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEHEE
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, RST
Authorized Official - Phone:912-388-4556
Mailing Address - Street 1:87 LINDSEY LANE
Mailing Address - Street 2:UNIT A
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6836
Mailing Address - Country:US
Mailing Address - Phone:912-576-6831
Mailing Address - Fax:912-576-6861
Practice Address - Street 1:993 YEOMANS ST
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-2083
Practice Address - Country:US
Practice Address - Phone:912-807-0904
Practice Address - Fax:912-807-0904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIANCE SLEEP CENTERS OF AMERICA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA528406168AMedicaid
GA528406168AMedicaid