Provider Demographics
NPI:1194296244
Name:LEBLEUCHATEAU, INC.
Entity type:Organization
Organization Name:LEBLEUCHATEAU, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-857-8218
Mailing Address - Street 1:1911 GRISMER AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-3624
Mailing Address - Country:US
Mailing Address - Phone:818-843-3141
Mailing Address - Fax:
Practice Address - Street 1:1911 GRISMER AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-3624
Practice Address - Country:US
Practice Address - Phone:818-843-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility