Organization
MIDDLEBURG-LEGACY PLACE, LLC
Active
Other names
Parkside Villa
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE DASKAL (PRESIDENT/CEO)
(216) 898-8399
Entity
Organization
Contact information
Practice address
7040 HEPBURN RD, CLEVELAND, OH 44130-4802
(216) 898-8399
(216) 898-8455
Mailing address
12380 PLAZA DR, PARMA, OH 44130-1043
(216) 898-8399
(216) 898-8455
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
6138
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2288975
—
OH
Enumeration date
09/26/2006
Last updated
08/22/2020
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