Provider Demographics
NPI:1669928974
Name:LEYSAN, LLC
Entity type:Organization
Organization Name:LEYSAN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-265-6616
Mailing Address - Street 1:1935 W MEADOW HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-3834
Mailing Address - Country:US
Mailing Address - Phone:520-265-6616
Mailing Address - Fax:520-415-1417
Practice Address - Street 1:1935 W MEADOW HILLS DR
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-3834
Practice Address - Country:US
Practice Address - Phone:520-415-1416
Practice Address - Fax:520-415-1417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ183610Medicaid
AZ150410Medicaid
AZ150410Medicaid