IndividualActive
January Blue
NPI 1750782595 · Adult Care Home Facility · N Las Vegas, NV
Provider details
- NPI number
- 1750782595
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 5002AGC-12 (NV)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1013 Stoneypeak Ave
N Las Vegas, NV 89081-3239
Phone: (702) 478-5252
Approximate (ZIP-level) locationGet directions
Mailing address
2608 Wooly Rose Ave
Las Vegas, NV 89106-1466
Registry dates
- Enumerated
- 2014-09-11
- Last updated
- 2014-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.