Provider Demographics
NPI:1396544342
Name:MIDDLEBURG-LEGACY PLACE, LLC
Entity type:Organization
Organization Name:MIDDLEBURG-LEGACY PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-590-0969
Mailing Address - Street 1:7040 HEPBURN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4802
Mailing Address - Country:US
Mailing Address - Phone:440-260-7626
Mailing Address - Fax:216-898-8455
Practice Address - Street 1:7040 HEPBURN RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4802
Practice Address - Country:US
Practice Address - Phone:440-260-7626
Practice Address - Fax:216-898-8455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDDLEBURG-LEGACY PLACE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility