# THE VICTORIAN HOUSE SLEEP CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477710689
- **Authorized official:** PEDRO MORENO SR. (OWNER)
- **Authorized official phone:** (505) 319-9617

## Contact information

- **Practice address:** 4036 CORRALES RD, CORRALES, NM 87048-9308
- **Practice address phone:** (505) 319-9617
- **Mailing address:** 5109 MENAUL BLVD NE, ALBUQUERQUE, NM 87110-3045
- **Mailing address phone:** (505) 888-6200
- **Mailing address fax:** (505) 888-6202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/16/2008
- **Last updated:** 05/16/2008