# IDAHO SLEEP SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Idaho Sleep Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275759441
- **Authorized official:** DR. DONALD J BEASLEY MD (MANAGER)
- **Authorized official phone:** (208) 463-3000

## Contact information

- **Practice address:** 210 GEORGIA AVE, STE 120, NAMPA, ID 83686
- **Practice address phone:** (208) 442-8222
- **Practice address fax:** (208) 442-8232
- **Mailing address:** PO BOX 3291, SALT LAKE CITY, UT 84110-3291
- **Mailing address phone:** (208) 375-8222
- **Mailing address fax:** (208) 375-8232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M9815 | ID | — |
| 177F00000X | Lodging Provider | — | NULL | — |
| 177F00000X | Lodging Provider | — | — | — |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | ID | Yes |
| 291U00000X | Clinical Medical Laboratory | — | ID | — |
| 293D00000X | Physiological Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 02/03/2011