Healthcare Provider Details

I. General information

NPI: 1669332375
Provider Name (Legal Business Name): LEJAX HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2985 S MERIDIAN RD STE 100
MERIDIAN ID
83642-8051
US

IV. Provider business mailing address

5392 W ROSSLARE DR
EAGLE ID
83616-6252
US

V. Phone/Fax

Practice location:
  • Phone: 208-481-4800
  • Fax:
Mailing address:
  • Phone: 208-481-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: NICKOLAS FRANSEN
Title or Position: LICENSED ACUPUNCTURIST
Credential: L.AC.
Phone: 760-473-3072