Organization
LEISURE HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KOKE AHANKOOB (PRESIDENT)
(818) 774-1236
Entity
Organization
Contact information
Practice address
1400 CIRCLE CITY DR, CORONA, CA 92879-1642
(909) 735-0252
(909) 735-0252
Mailing address
19528 VENTURA BLVD # 589, TARZANA, CA 91356-2917
(818) 774-1236
(818) 774-0563
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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