Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Leisure Village Inc

Organization Assisted Living Facility · NPI 1366991135

Leisure Village Inc is an Assisted Living Facility in Lake Balboa, California. Licensed in California. Registered with an NPI since 2016.

Licensed in
CA
In the registry since
2016
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6728 Gaviota Ave
Lake Balboa, CA 91406-5944
Phone: (818) 585-2200
Fax: (818) 387-6445
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 197607543 (CA)

Record details

NPI number1366991135
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Koke Ahankoob — President · (818) 585-2200
NPI enumeratedSeptember 22, 2016
Last updated in NPPESSeptember 22, 2016
Mailing address6728 Gaviota Ave, Lake Balboa, CA 91406-5944

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