Provider Demographics
NPI:1487920781
Name:LANGDON HALL HEALTHCARE GROUP, LLC
Entity type:Organization
Organization Name:LANGDON HALL HEALTHCARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:I
Authorized Official - Last Name:WEISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-5706
Mailing Address - Street 1:26691 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1421
Mailing Address - Country:US
Mailing Address - Phone:216-292-5706
Mailing Address - Fax:216-292-2273
Practice Address - Street 1:1120 33RD AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-6219
Practice Address - Country:US
Practice Address - Phone:941-744-1923
Practice Address - Fax:941-744-1924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SABER HEALTHCARE HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-30
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10661310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility