Organization
COOPER LEGACY HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DASHAE C COOPER (OWNER)
(216) 253-8502
Entity
Organization
Contact information
Practice address
5243 BROADWAY AVE, CLEVELAND, OH 44127-1504
(216) 253-8502
Mailing address
5243 BROADWAY AVE, CLEVELAND, OH 44127-1504
(216) 253-8502
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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