LEISURE VILLAGE INC (NPI# 1366991135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366991135 |
| Entity Type | Organization |
| Organization Name | LEISURE VILLAGE INC |
| Practice Address |
6728 Gaviota Ave Lake Balboa CA 91406-5944 |
| Practice Telephone | 8185852200 |
| Practice Fax Number | 8183876445 |
| Mailing Telephone | 8185852200 |
| Mailing Fax Number | 8183876445 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |
| Authorized Official Name | KOKE AHANKOOB (PRESIDENT) |
| Authorized Official Telephone | 8185852200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 197607543 | CA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598936205 | Leisure Village Inc | Assisted Living Facility | 6726 Gaviota Ave, Lake Balboa, CA 91406-5944 | 2008-03-20 |
| Street Address |
6728 GAVIOTA AVE |
| City | LAKE BALBOA |
| State | CA |
| Zip Code | 91406-5944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628953 | Elizabeth Leon Sanchez | Marriage & Family Therapist | 16360 Van Nuys Blvd, Van Nuys, CA 91406 | 2019-09-18 |
| 1720573926 | Kina Dennis | Specialist/Technologist | 17216 Saticoy Street, 609, Van Nuys, CA 91406 | 2018-06-29 |
| 1902398951 | Roland Hinds | Rehabilitation Practitioner | 16360 Roscoe Blvd # 2, Van Nuys, CA 91406 | 2018-06-05 |
| 1528576691 | Vyacheslav Alec Pekler | Naturopath | 7025 Adea Ave, Lake Balboa, CA 91406 | 2018-01-11 |
| 1366960999 | Gentle Ride LLC Dba Safeaid | Non-emergency Medical Transport (VAN) | 6747 Odessa Ave Ste 101, Van Nuys, CA 91406 | 2017-09-04 |
| 1396265252 | Developmental Pathways, Inc. | Physical Therapist | 7120 Hayvenhurst Ave Ste 308, Van Nuys, CA 91406 | 2017-06-22 |
| 1952850729 | Leisure Village, Inc | Assisted Living Facility | 6726 1/2 Gaviota Ave., Lake Balboa, CA 91406 | 2016-09-22 |
| 1689037426 | Mahnaz Rashidimoakhar | Physical Therapy Assistant | 6452 Woodley Ave, Unit 4, Van Nuys, CA 91406 | 2016-03-30 |
| 1306264205 | Angel Hospice Care, Inc. | Hospice Care, Community Based | 16114 Hart St, Van Nuys, CA 91406 | 2014-03-29 |
| 1871924589 | Well Care Transport, Inc. | Non-emergency Medical Transport (VAN) | 6525 Woodley Ave. Unit #205, Lake Balboa, CA 91406 | 2013-12-05 |
| Find all providers in zip 91406 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952850729 | Leisure Village, Inc | Assisted Living Facility | 6726 1/2 Gaviota Ave., Lake Balboa, CA 91406 | 2016-09-22 |
| 1598936205 | Leisure Village Inc | Assisted Living Facility | 6726 Gaviota Ave, Lake Balboa, CA 91406-5944 | 2008-03-20 |
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|---|---|---|---|---|
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| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | LAKE BALBOA |
| Zip Code | 91406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.