# LEISURE TERRACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275903601
- **Authorized official:** SHIMON WEBSTER (MANAGER/MEMBER)
- **Authorized official phone:** (773) 945-1107

## Contact information

- **Practice address:** 5211 W 103RD ST, OVERLAND PARK, KS 66207-3154
- **Practice address phone:** (913) 383-2569
- **Mailing address:** 8153 LAWNDALE AVE, SKOKIE, IL 60076-3321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2015
- **Last updated:** 05/24/2016