MEDICARE: JSI ACQUISITION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	171W00000X	Contractor
3	251X00000X	Supports Brokerage Agency
4	3747P1801X	Personal Care Attendant
5	385H00000X	Respite Care
6	251E00000X	Home Health Agency	980000470	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013967314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JSI ACQUISITION, INC.

Provider Business Mailing Address
First Line	:	5805 SEPULVEDA BLVD
Second Line	:	SUITE 605
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91411-2546
Country	:	US
Telephone Number	:	818-902-5000
Fax Number	:	818-902-5008

Provider Business Practice Location Address
First Line	:	5805 SEPULVEDA BLVD
Second Line	:	SUITE 605
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91411-2546
Country	:	US
Telephone Number	:	818-902-5000
Fax Number	:	818-902-5008

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JONATHAN ISTRIN
Credential	:
Telephone Number	:	818-902-5000

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	06/29/2022

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Directions to “JSI ACQUISITION, INC. ” Practice Location

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