# LEISURE HOMES INC

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

## Provider details

- **NPI number:** 1376734434
- **Authorized official:** MR. KOKE AHANKOOB (PRESIDENT)
- **Authorized official phone:** (818) 774-1236

## Contact information

- **Practice address:** 1400 CIRCLE CITY DR, CORONA, CA 92879-1642
- **Practice address phone:** (909) 735-0252
- **Practice address fax:** (909) 735-0252
- **Mailing address:** 19528 VENTURA BLVD \# 589, TARZANA, CA 91356-2917
- **Mailing address phone:** (818) 774-1236
- **Mailing address fax:** (818) 774-0563

## Taxonomy

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

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 08/05/2007