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General NPI Number Information
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NPI Number | 1629381108
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Entity Type | Organization
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Legal Business Name | LESMONI INCORPORATION
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 5241 CEDAR RIDGE WAY
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City | ANTIOCH
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State | CA
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Zip | 94531-8097
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Country | US
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Telephone | 925-757-1379
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Fax | 925-978-2761
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Provider Business Mailing Address
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Address Line | 5241 CEDAR RIDGE WAY
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City | ANTIOCH
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State | CA
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Zip | 94531-8097
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Country | US
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Telephone | 925-757-1379
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Fax | 925-978-2761
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MRS. JUDITH CONMIGO ABESAMIS
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Credential | REGISTERED NURSE
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Telephone | 925-325-5344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 550001183
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License Number State | CA
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