Organization
BURGUNDI MANOR OPERATING COMPANY, LLC
Active
Other names
Danridge's Burgundi Manor
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL B. BERGSTEN (CEO)
(937) 825-6622
Entity
Organization
Contact information
Practice address
31 MARANTHA DRIVE, YOUNGSTOWN, OH 44505-4505
(330) 746-5157
(330) 746-2508
Mailing address
31 MARANATHA CT, YOUNGSTOWN, OH 44505-4970
(330) 746-5157
(330) 746-2508
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2232N
OH
314000000X
Skilled Nursing Facility
2232NH
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0364950001
DEMERC
OH
05
—
2089396
—
OH
05
—
3102127
—
OH
Enumeration date
06/26/2006
Last updated
07/14/2016
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