LEISURE VILLAGE INC
NPI 1366991135
Assisted Living Facility in Lake Balboa, CA

Q: What is Leisure Village Inc's NPI number?

The NPI number for Leisure Village Inc is 1366991135. It was assigned to this organization in the NPPES registry on September 22, 2016.

Q: What is Leisure Village Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since September 22, 2016

6728 GAVIOTA AVE, LAKE BALBOA, CA 91406(818) 585-2200(818) 387-6445 Get Directions Write a Review

NPPES record last updated: September 22, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Leisure Village Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEISURE VILLAGE INC (NPI 1366991135) is a healthcare organization registered as an assisted living facility in Lake Balboa, California and active in the NPI registry since September 2016. The organization lists Koke Ahankoob, President, as its authorized official.

NPPES Registry Identity

NPI1366991135

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameLEISURE VILLAGE INC

Location Address6728 GAVIOTA AVELake Balboa, CA 91406-5944

Mailing Address6728 Gaviota AveLake Balboa, CA 91406-5944 · (818) 585-2200 · Fax (818) 387-6445

Phone(818) 585-2200

Fax(818) 387-6445

Organization SubpartNo

Authorized OfficialKoke AhankoobPresident · (818) 585-2200

Enumeration DateSeptember 22, 2016

✔ NPI 1366991135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in CA · 197607543

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

6728 GAVIOTA AVE, Lake Balboa, CA 91406

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leisure Village Inc's NPI number?

The NPI number for Leisure Village Inc is 1366991135. It was assigned to this organization in the NPPES registry on September 22, 2016.

Where is Leisure Village Inc located?

Leisure Village Inc is located at 6728 Gaviota Ave, Lake Balboa, CA 91406. The listed phone number is (818) 585-2200.

What is Leisure Village Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Leisure Village Inc was last updated on September 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.