Provider Demographics
NPI:1629381108
Name:LESMONI INCORPORATION
Entity type:Organization
Organization Name:LESMONI INCORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:CONMIGO
Authorized Official - Last Name:ABESAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:925-325-5344
Mailing Address - Street 1:5241 CEDAR RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8097
Mailing Address - Country:US
Mailing Address - Phone:925-757-1379
Mailing Address - Fax:925-978-2761
Practice Address - Street 1:5241 CEDAR RIDGE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8097
Practice Address - Country:US
Practice Address - Phone:925-757-1379
Practice Address - Fax:925-978-2761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001183313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility