Provider Demographics
NPI:1578201620
Name:DOHS, JOHN HARVEY
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HARVEY
Last Name:DOHS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9417 N 17TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2310
Mailing Address - Country:US
Mailing Address - Phone:520-661-2594
Mailing Address - Fax:
Practice Address - Street 1:9417 N 17TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2310
Practice Address - Country:US
Practice Address - Phone:520-661-2594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities