Provider Demographics
NPI:1003304551
Name:THOMAS AND THOMAS PCA, LLC
Entity Type:Organization
Organization Name:THOMAS AND THOMAS PCA, LLC
Other - Org Name:DOSKA PROJECT WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-777-8179
Mailing Address - Street 1:911 G ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3313
Mailing Address - Country:US
Mailing Address - Phone:725-777-8179
Mailing Address - Fax:
Practice Address - Street 1:911 G ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3313
Practice Address - Country:US
Practice Address - Phone:725-777-8179
Practice Address - Fax:702-386-0680
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOSKA PROJECT WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-30
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV201813062363747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty