DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JESOLA INC

MEDICARE: JESOLA 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

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

General Provider Information

NPI Number : 1861497190
Entity Type Code : Organization
Provider Name (Legal Business Name) : JESOLA INC
Provider Business Mailing Address
First Line : 1000 8TH ST SE
Second Line : STE A
City : DETROIT LAKES
State : MN
Zip : 56501-2819
Country : US
Telephone Number : 218-847-0696
Fax Number : 218-847-4198
Provider Business Practice Location Address
First Line : 1000 8TH ST SE
Second Line : STE A
City : DETROIT LAKES
State : MN
Zip : 56501-2819
Country : US
Telephone Number : 218-847-0696
Fax Number : 218-847-4198
Authorized Official
Title or Position : OWNER/DIRECTOR
Name : JESSICA RAE MOENCH
Credential : BS, LADC
Telephone Number : 218-396-0288
Provider Enumeration Date : 06/14/2005
Last Update Date : 12/10/2024

Similar Medicare Providers

1275711608 — EDWARD RAY PACHEL LADC
Practice Location Address:
1000 8TH ST SE
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198
1164600599 — JAMES ARTHUR THOM LAC
Practice Location Address:
1000 8TH ST SE
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198
1487822458 — MS. TERI ELLEN CAIN LADC
Practice Location Address:
1000 8TH ST SE
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198
1295984771 — TERRY JO WOOD LADC
Practice Location Address:
1000 8TH ST SE
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198
1295964518 — LARRY W BOOMGAARDEN B.A., LAC-T
Practice Location Address:
1000 8TH ST SE
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198
1104132505 — JESSICA RAE MOENCH LADC, OWNER/DIRECTOR
Practice Location Address:
1000 8TH ST SE STE A
DETROIT LAKES, MN
56501-2819
Practice Phone: 218-847-0696
Practice Fax: 218-847-4198

Directions to “JESOLA INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.