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General NPI Number Information
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NPI Number | 1174442529
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Entity Type | Organization
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Legal Business Name | MICAH MISSION INC
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 921 W LAUREL AVE
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City | LOMPOC
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State | CA
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Zip | 93436-5214
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Country | US
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Telephone | 805-260-6724
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Fax |
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Provider Business Mailing Address
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Address Line | 921 W LAUREL AVE
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City | LOMPOC
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State | CA
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Zip | 93436-5214
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Country | US
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Telephone | 805-260-6724
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF MINISTRIES
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Name | KELSEY BARELA
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Credential |
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Telephone | 805-717-1731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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