NPIMap

Organization Active NPI

Leisure Village

  • Assisted Living Facility
  • Tarzana, CA
National Provider Identifier
1003360124
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
197607542 Issued in CA
Legal business name
LEISURE VILLAGE
Practice address
19562 Ventura Blvd Ste 229
Tarzana, CA 91356-7126
Phone
(818) 585-2200
NPI assigned
Aug 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Koke Ahankoob
Title
President
Phone
(818) 402-7867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 197607542 CA Primary

Addresses

Primary practice location

19562 Ventura Blvd Ste 229
Tarzana, CA 91356-7126

Mailing address

19562 Ventura Blvd Ste 229
Tarzana, CA 91356-7126
Phone (818) 585-2200

National Provider Directory

National Provider Directory
Tax ID family
Leisure Village Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1003360124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19562 VENTURA BLVD STE 229",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567126",
            "telephone_number": "818-585-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19562 VENTURA BLVD STE 229",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913567126",
            "telephone_number": "818-585-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "AHANKOOB",
        "authorized_official_first_name": "KOKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-402-7867"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197607542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.