Provider Demographics
NPI:1356468946
Name:LEVY GARDENS
Entity Type:Organization
Organization Name:LEVY GARDENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:330-746-3570
Mailing Address - Street 1:584 GRANADA AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2422
Mailing Address - Country:US
Mailing Address - Phone:330-746-3570
Mailing Address - Fax:330-746-3781
Practice Address - Street 1:584 GRANADA AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2422
Practice Address - Country:US
Practice Address - Phone:330-746-3570
Practice Address - Fax:330-746-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRCF2153310400000X
OHATM2065347B00000X
OHCD02UU347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered347B00000XTransportation ServicesBus
Not Answered347C00000XTransportation ServicesPrivate Vehicle