Provider Demographics
NPI:1952545527
Name:JES HOME & HEALTH CARE SERVICES PROVIDER LLC
Entity Type:Organization
Organization Name:JES HOME & HEALTH CARE SERVICES PROVIDER LLC
Other - Org Name:JES HEALTHCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:TEVES
Authorized Official - Last Name:TUZARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-488-8909
Mailing Address - Street 1:PO BOX 1909
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92702-1909
Mailing Address - Country:US
Mailing Address - Phone:714-834-9742
Mailing Address - Fax:714-834-9742
Practice Address - Street 1:2001 N FLOWER ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2523
Practice Address - Country:US
Practice Address - Phone:714-834-9742
Practice Address - Fax:714-834-9742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health