MEDICARE: DOSKA PROJECT WELLNESS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568981223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOSKA PROJECT WELLNESS CENTER

Provider Business Mailing Address
First Line	:	911 G ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3313
Country	:	US
Telephone Number	:	725-200-1547
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 G ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3313
Country	:	US
Telephone Number	:	725-200-1547
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JENNIFER D THOMAS
Credential	:
Telephone Number	:	725-777-8179

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	09/14/2017

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Directions to “DOSKA PROJECT WELLNESS CENTER ” Practice Location

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