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General NPI Number Information
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NPI Number | 1487505327
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Entity Type | Organization
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Legal Business Name | HOME OF JANUARY, LLC
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1549 ANTOINE DR
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City | SAN DIEGO
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State | CA
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Zip | 92139-3949
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Country | US
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Telephone | 619-808-5196
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Fax |
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Provider Business Mailing Address
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Address Line | 1549 ANTOINE DR
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City | SAN DIEGO
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State | CA
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Zip | 92139-3949
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Country | US
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Telephone | 619-808-5196
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KIESHA L MILLER
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Credential |
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Telephone | 619-808-5196
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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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