LEISURE VILLAGE, INC (NPI# 1952850729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952850729 |
| Entity Type | Organization |
| Organization Name | LEISURE VILLAGE, INC |
| Practice Address |
6726 1/2 Gaviota Ave. Lake Balboa CA 91406 |
| Mailing Address |
19562 Ventura Blvd Suite 229 Tarzana CA 91356-2955 |
| Practice Telephone | 8185852200 |
| Mailing Telephone | 8185852200 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | LEISURE VILLAGE, INC. | 4225 State Route 69, Taberg, New York 13471 |
| Street Address |
6726 1/2 GAVIOTA AVE. |
| City | LAKE BALBOA |
| State | CA |
| Zip Code | 91406 |
| 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 |
| 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 |
| 1265870646 | Anna Parfyonova | Marriage & Family Therapist | 16360 Roscoe Blvd., 2nd Floor, Van Nuys, CA 91406 | 2013-06-07 |
| 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 |
|---|---|---|---|---|
| 1366991135 | Leisure Village Inc | Assisted Living Facility | 6728 Gaviota Ave, Lake Balboa, CA 91406-5944 | 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 |
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| 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.