Organization
LEISURE TERRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIMON WEBSTER (MANAGER/MEMBER)
(773) 945-1107
Entity
Organization
Contact information
Practice address
5211 W 103RD ST, OVERLAND PARK, KS 66207-3154
(913) 383-2569
Mailing address
8153 LAWNDALE AVE, SKOKIE, IL 60076-3321
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/28/2015
Last updated
05/24/2016
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