Provider Demographics
NPI:1679867659
Name:JESLIA INC
Entity Type:Organization
Organization Name:JESLIA INC
Other - Org Name:SYNERGY HOMECARE OF FOLSOM LAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-351-0794
Mailing Address - Street 1:13405 FOLSOM BLVD
Mailing Address - Street 2:SUITE 513
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4737
Mailing Address - Country:US
Mailing Address - Phone:916-351-0794
Mailing Address - Fax:888-472-0883
Practice Address - Street 1:13405 FOLSOM BLVD
Practice Address - Street 2:SUITE 513
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4737
Practice Address - Country:US
Practice Address - Phone:916-351-0794
Practice Address - Fax:888-472-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care