1. Home
  2. Directory
  3. California
  4. Lake Balboa
  5. Assisted Living Facility
  6. NPI Profile

LEISURE VILLAGE, INC
NPI 1952850729
Assisted Living Facility in Lake Balboa, CA

Active since September 22, 2016
6726 1/2 GAVIOTA AVE., LAKE BALBOA, CA 91406(818) 585-2200 Get Directions Write a Review

NPPES record last updated: September 22, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Leisure Village, Inc NPPES

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

LEISURE VILLAGE, INC (NPI 1952850729) 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

NPI1952850729
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLEISURE VILLAGE, INC
Location Address6726 1/2 GAVIOTA AVE.Lake Balboa, CA 91406
Mailing Address19562 Ventura Blvd, Suite 229Tarzana, CA 91356-2955 · (818) 585-2200
Phone(818) 585-2200
Organization SubpartNo
Authorized OfficialKoke AhankoobPresident · (818) 585-2200
Enumeration DateSeptember 22, 2016
✔ NPI 1952850729 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.
6726 1/2 GAVIOTA AVE., Lake Balboa, CA 91406
Open in Google Maps ↗

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 1952850729. 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 6726 1/2 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.