MEDICARE: TIMELESS HOPE 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

General Provider Information

NPI Number	:	1407677800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMELESS HOPE WELLNESS CENTER

Provider Business Mailing Address
First Line	:	3226 SUNRISE COVE AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-0589
Country	:	US
Telephone Number	:	312-420-1106
Fax Number	:

Provider Business Practice Location Address
First Line	:	3226 SUNRISE COVE AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-0589
Country	:	US
Telephone Number	:	312-420-1106
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JABREIA CRAFT
Credential	:
Telephone Number	:	312-420-1106

Provider Enumeration Date	:	10/18/2024
Last Update Date	:	10/18/2024

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Directions to “TIMELESS HOPE WELLNESS CENTER ” Practice Location

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