Leisure Village Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH7216-7216 Issued in OK

Legal business name

LEISURE VILLAGE OPERATING LLC

Doing business as

Leisure Village Health Care

Practice address

2154 S 85TH East Ave
Tulsa, OK 74129-3012

Phone

(918) 622-4747

Fax

(918) 622-0304

NPI assigned

Jul 13, 2005

Last updated

Jun 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Diane H. Hambric

Title

Vice President

Phone

(918) 523-0222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Leisure Village Health Care Doing business as

Locations

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1760480768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 E 51ST ST STE H",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353705",
            "telephone_number": "918-523-0222",
            "fax_number": "918-523-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 S 85TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741293012",
            "telephone_number": "918-622-4747",
            "fax_number": "918-622-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE VILLAGE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "HAMBRIC",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "918-523-0222",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH7216-7216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200054790A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leisure Village Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Kenneth Leifeste, MS, LPC
• Katherine Jolene Leiker
• Wayne N Leimbach, M.D.
• Vicki R Leist, APRN-CNS
• Leisure Village Health Care (Leisure Village Health Care Center)
• Joel Steven Leitch, LPC, CADC
• Caroline Leithner, APRN
• Anna Darlann Leland, BA
• Sherry Leland
• Cassie Loren Lemaster, APRN FNP-C

• Skilled Nursing Facility in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.