Individual ProviderJason ThollBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address4000 San Ernesto Ave, Anchorage, AK 99508-2874(907) 729-5020PECOS EnrollmentBased on the most recent information from CMS, provider Jason Tholl does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1528679388Provider TypeIndividualFull NameTholl, JasonGenderMaleSole ProprietorNoEnumeration Date8/13/2020Last Updated8/13/2020Contact InformationPractice LocationPractice Address4000 San Ernesto Ave, Anchorage, AK 99508-2874Phone(907) 729-5020FaxUnlisted FaxMailing LocationMailing Address7033 E Tudor Rd, Anchorage, AK 99507-1262Phone(907) 729-5020FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerAlaska