Healthcare Provider Details

I. General information

NPI: 1356468946
Provider Name (Legal Business Name): LEVY GARDENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 GRANADA AVE
YOUNGSTOWN OH
44505-2422
US

IV. Provider business mailing address

505 GYPSY LN
YOUNGSTOWN OH
44504-1314
US

V. Phone/Fax

Practice location:
  • Phone: 330-746-3570
  • Fax: 330-746-3781
Mailing address:
  • Phone: 330-746-3570
  • Fax: 330-746-3781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberCD02UU
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License NumberATM2065
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberRCF2153
License Number StateOH

VIII. Authorized Official

Name: DAVID JOHN STAUFFER
Title or Position: CFO
Credential:
Phone: 330-746-3251