Leisure Village INC
NPI #1366991135 in Lake Balboa, California
Provider Information
- NPI Number
- 1366991135
- Entity Type
- Organization
- Organization Name
- Leisure Village INC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Sep 22, 2016
- Last Updated
- Sep 22, 2016
Practice Location
- Address
- 6728 GAVIOTA AVE
- City
- Lake Balboa
- State
- California
- ZIP Code
- 91406-5944
- Phone
- (818) 585-2200
Authorized Official
- Name
- KOKE AHANKOOB
- Title
- PRESIDENT
- Phone
- (818) 585-2200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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