MEDICARE: LEVY GARDENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle	CD02UU	OH
2	347B00000X	Bus	ATM2065	OH
3	310400000X	Assisted Living Facility	RCF2153	OH

General Provider Information

NPI Number	:	1356468946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEVY GARDENS

Provider Business Mailing Address
First Line	:	505 GYPSY LN
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44504-1314
Country	:	US
Telephone Number	:	330-746-3570
Fax Number	:	330-746-3781

Provider Business Practice Location Address
First Line	:	584 GRANADA AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-2422
Country	:	US
Telephone Number	:	330-746-3570
Fax Number	:	330-746-3781

Authorized Official
Title or Position	:	CFO
Name	:	DAVID JOHN STAUFFER
Credential	:
Telephone Number	:	330-746-3251

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	04/27/2026

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Directions to “LEVY GARDENS ” Practice Location

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