Provider Demographics
NPI:1013967314
Name:JSI ACQUISITION, INC.
Entity Type:Organization
Organization Name:JSI ACQUISITION, INC.
Other - Org Name:LIBERTANA HOME HEALTH OF SHERMAN OAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISTRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-902-5000
Mailing Address - Street 1:5805 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2546
Mailing Address - Country:US
Mailing Address - Phone:818-902-5000
Mailing Address - Fax:818-902-5008
Practice Address - Street 1:5805 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 605
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-2546
Practice Address - Country:US
Practice Address - Phone:818-902-5000
Practice Address - Fax:818-902-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 171W00000X, 251X00000X, 3747P1801X, 385H00000X
CA980000470251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No251X00000XAgenciesSupports BrokerageGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAA70244FMedicaid
CAHAA70244FMedicaid
CA057657Medicare Oscar/Certification