# IMMORTELLE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Immortelle Med
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922767250
- **Authorized official:** JESSICA JACOBSON (OWNER/PRESIDENT)
- **Authorized official phone:** (424) 355-9023

## Contact information

- **Practice address:** 300 S DOHENY DR STE 510, LOS ANGELES, CA 90048-3704
- **Practice address phone:** (424) 355-9023
- **Practice address fax:** (424) 389-7037
- **Mailing address:** 640 S SAN VICENTE BLVD STE 264, LOS ANGELES, CA 90048-4884
- **Mailing address phone:** (424) 271-0010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/14/2021
- **Last updated:** 04/18/2026