Leisure Village INC
NPI #1598936205 in Lake Balboa, California
Provider Information
- NPI Number
- 1598936205
- Entity Type
- Organization
- Organization Name
- Leisure Village INC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Mar 20, 2008
- Last Updated
- Mar 20, 2008
Practice Location
- Address
- 6726 GAVIOTA AVE
- City
- Lake Balboa
- State
- California
- ZIP Code
- 91406-5944
- Phone
- (818) 402-7867
Authorized Official
- Name
- MR. KOKE AHANKOOB
- Title
- PRESIDENT
- Phone
- (818) 402-7867
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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