Provider Demographics
NPI:1811102791
Name:LESMONI INC
Entity type:Organization
Organization Name:LESMONI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ABESAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-757-1379
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
Mailing Address - Country:UM
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:2007-05-13
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALTC80387F313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC80387FMedicaid