MEDICARE: JEM C ENTERPRISES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1538989892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEM C ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	1652 W TEXAS ST STE 127
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-5952
Country	:	US
Telephone Number	:	224-432-3783
Fax Number	:	707-430-5050

Provider Business Practice Location Address
First Line	:	1652 W TEXAS ST STE 127
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-5952
Country	:	US
Telephone Number	:	224-432-3783
Fax Number	:	707-430-5050

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CRISTINA MALLARI
Credential	:	REGISTERED NURSE
Telephone Number	:	224-432-3783

Provider Enumeration Date	:	10/11/2024
Last Update Date	:	04/16/2026

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Directions to “JEM C ENTERPRISES LLC ” Practice Location

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