Individual provider · Type 1 NPI
January Blue
Adult Care Home Facility · North Las Vegas, NV
NPI number
1750782595
Active
Practice location
1013 Stoneypeak Ave
North Las Vegas, NV 89081-3239
Mailing address
2608 Wooly Rose Ave
Las Vegas, NV 89106-1466
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 5002AGC-12 (NV) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Another provider at this address
Other adult care home facility providers in North Las Vegas
About NPI 1750782595
January Blue's National Provider Identifier is 1750782595, issued on Sep 11, 2014. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in North Las Vegas, NV. The record was last updated on Sep 15, 2014.