MEDICARE: JA'BREIA CRAFT

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	:	1770477077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JA'BREIA CRAFT

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

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/03/2025

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