TRINIDAD ASSISTED LIVING LLC NPI 1477927440

NPI Information

NPI: 1477927440
Provider Name: TRINIDAD ASSISTED LIVING, LLC

Doing Business As: THE LEGACY AT TRINIDAD

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 06D2231963

Address:
33 LEGACY LN
TRINIDAD, CO
ZIP 81082
Phone: (719) 846-8662
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TRINIDAD ASSISTED LIVING, LLC is an assisted living facility in Trinidad, CO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. TRINIDAD ASSISTED LIVING, LLC NPI is 1477927440. The provider is registered as an organization entity type.
The provider Is Doing Business As The Legacy At Trinidad.

The provider's business location address is:

33 LEGACY LN
TRINIDAD, CO
ZIP 81082-300
Phone: (719) 846-8662

The provider's authorized official is David B Beardsley .
The authorized official title is President and has the following contact phone number (423) 596-0169.

The CLIA number assigned to this NPI record is 06D2231963 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/13/2015 and was last updated on 11/13/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		23Z790	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	48738336	MEDICAID	COLORADO
2	23Z790	OTHER	COLORADO	COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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