MEDICARE: SKILLS ON WHEELS, LLC

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1699119073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKILLS ON WHEELS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 335816
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89033-5816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4725 BELL CANYON CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2564
Country	:	US
Telephone Number	:	702-644-0117
Fax Number	:	702-644-0177

Authorized Official
Title or Position	:	DIRECTOR
Name	:	YONA T. CHILDRESS
Credential	:	MSW
Telephone Number	:	702-644-0117

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	07/30/2015

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Directions to “SKILLS ON WHEELS, LLC ” Practice Location

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