Organization
LESAN ASSISTED LIVING, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENE LEON JR. (OWNER AND MANAGER)
(520) 234-5776
Entity
Organization
Contact information
Practice address
2340 E PRIMROSE ST, DOUGLAS, AZ 85607-5102
(520) 505-6528
Mailing address
2340 E PRIMROSE ST, DOUGLAS, AZ 85607-5102
(520) 505-6528
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10280H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260616
—
AZ
Enumeration date
07/20/2017
Last updated
11/08/2021
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