Organization
IMMORTELLE INC
Active
Other names
Immortelle Med
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA JACOBSON (OWNER/PRESIDENT)
(424) 355-9023
Entity
Organization
Contact information
Practice address
300 S DOHENY DR STE 510, LOS ANGELES, CA 90048-3704
(424) 355-9023
(424) 389-7037
Mailing address
640 S SAN VICENTE BLVD STE 264, LOS ANGELES, CA 90048-4884
(424) 271-0010
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/14/2021
Last updated
04/18/2026
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