Basic Information
| Provider Information | |||||||||
| NPI: | 1730324849 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOME START, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 TEXAS ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196920785 | ||||||||
| FaxNumber: | 6196920785 | ||||||||
| Practice Location | |||||||||
| Address1: | 5005 TEXAS ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196920727 | ||||||||
| FaxNumber: | 6196920785 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2008 | ||||||||
| LastUpdateDate: | 12/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | JONES | ||||||||
| AuthorizedOfficialFirstName: | TRACEY | ||||||||
| AuthorizedOfficialMiddleName: | LYNN | ||||||||
| AuthorizedOfficialTitleorPosition: | INTERN | ||||||||
| AuthorizedOfficialTelephone: | 6196920727 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | ASW24487 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.