Contract Details
Ancillary Care Services
Facility name
Sleep Management Institute
Provider ID
P000006118
Tax ID
205208581
Effective Date
4/1/2012
Last Updated
10/21/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
3157 Villa Way
Jasper, IN 47546
United States
County
Dubois
Phone
8124811780 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Sleep Medicine
Map
Address