MEDICARE: JES HOME & HEALTH CARE SERVICES PROVIDER 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	:	1952545527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JES HOME & HEALTH CARE SERVICES PROVIDER LLC

Provider Business Mailing Address
First Line	:	PO BOX 1909
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92702-1909
Country	:	US
Telephone Number	:	714-834-9742
Fax Number	:	714-834-9742

Provider Business Practice Location Address
First Line	:	2001 N FLOWER ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-2523
Country	:	US
Telephone Number	:	714-834-9742
Fax Number	:	714-834-9742

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. EDWIN TEVES TUZARA
Credential	:
Telephone Number	:	714-488-8909

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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