Healthcare Provider Details

I. General information

NPI: 1689830499
Provider Name (Legal Business Name): JSI ACQUISITION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 SEPULVEDA BLVD SUITE 740
VAN NUYS CA
91411-2546
US

IV. Provider business mailing address

5805 SEPULVEDA BLVD SUITE 740
VAN NUYS CA
91411-2546
US

V. Phone/Fax

Practice location:
  • Phone: 818-902-5000
  • Fax: 818-902-5008
Mailing address:
  • Phone: 818-902-5000
  • Fax: 818-902-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980000470
License Number StateCA

VIII. Authorized Official

Name: MR. JONATHAN ISTRIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 818-902-5000