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	251E00000X	Home Health Agency	980000470	CA

General Provider Information

NPI Number	:	1689830499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JSI ACQUISITION, INC.

Provider Business Mailing Address
First Line	:	5805 SEPULVEDA BLVD
Second Line	:	SUITE 740
City	:	VAN NUYS
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 740
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2546
Country	:	US
Telephone Number	:	818-902-5000
Fax Number	:	818-902-5008

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

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	07/31/2008

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