Healthcare Provider Details

I. General information

NPI: 1396544342
Provider Name (Legal Business Name): MIDDLEBURG-LEGACY PLACE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7040 HEPBURN RD
MIDDLEBURG HEIGHTS OH
44130-4802
US

IV. Provider business mailing address

7040 HEPBURN RD
MIDDLEBURG HEIGHTS OH
44130-4802
US

V. Phone/Fax

Practice location:
  • Phone: 440-260-7626
  • Fax: 216-898-8455
Mailing address:
  • Phone: 440-260-7626
  • Fax: 216-898-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMES J TAYLOR
Title or Position: CEO
Credential:
Phone: 440-590-0969