Organization
LEGACY ON 10TH OPCO, LLC
Active
Other names
Legacy on 10th Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (MANAGER)
(312) 724-8950
Entity
Organization
Contact information
Practice address
2015 SE 10TH AVE, TOPEKA, KS 66607-1615
(785) 313-0946
Mailing address
1633 N CAMPBELL AVE, CHICAGO, IL 60647-5203
(312) 724-8950
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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