| NPI | 1962411355 |
|---|---|
| Doing Business As | LESLIE LAKES RETIREMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | DAWNE R SMITH CEO 318-812-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 859) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2014-02-14 |