# 1135 N LEISURE CT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LEISURE COURT NURSING CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033106703
- **Authorized official:** MR. JOHN HENRY SY (VP OF REVENUE MANAGEMENT)
- **Authorized official phone:** (562) 930-0777

## Contact information

- **Practice address:** 1135 N LEISURE CT, ANAHEIM, CA 92801-2939
- **Practice address phone:** (714) 772-1353
- **Practice address fax:** (714) 490-2171
- **Mailing address:** 4115 E BROADWAY, LONG BEACH, CA 90803-1532
- **Mailing address phone:** (562) 930-0777
- **Mailing address fax:** (562) 930-0728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 060000119 | CA | Yes |

## Other

- **Enumeration date:** 09/28/2005
- **Last updated:** 05/28/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55520G | — | CA |