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Organization
VITAL SLEEP CENTER, PLLC
Active
Organization
VITAL SLEEP CENTER, PLLC
Active
Parent organization
PHOENIX MEDICAL GROUP, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX MEDICAL GROUP, PC
Authorized official
MRS. ABBIE HILL (ADMINISTRATOR)
(248) 304-7674
Entity
Organization
Contact information
Practice address
29201 TELEGRAPH RD STE 240, SOUTHFIELD, MI 48034-1331
(248) 304-7774
(248) 918-2025
Mailing address
29201 TELEGRAPH RD STE 450, SOUTHFIELD, MI 48034-7604
(248) 304-7659
(248) 479-8117
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306075551
—
MI
Enumeration date
12/23/2014
Last updated
03/22/2018
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