Healthcare Provider Details

I. General information

NPI: 1114320694
Provider Name (Legal Business Name): ISLM LEASING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 LAGUNA DR STE A
CARLSBAD CA
92008-1698
US

IV. Provider business mailing address

550 LAGUNA DR STE A
CARLSBAD CA
92008-1698
US

V. Phone/Fax

Practice location:
  • Phone: 760-547-2863
  • Fax:
Mailing address:
  • Phone: 760-547-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: VINCE LIMBURG
Title or Position: VP OF ACCOUNTING & FINANCE
Credential:
Phone: 760-547-2863