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LEGACY RESIDENTIAL PROGRAM NPI 1003506171


NPI Information

NPI: 1003506171
Provider Name: LEGACY RESIDENTIAL PROGRAM
Classification: Case Management - 251B00000X
Entity Type: Organization
Address:
2156 N 30TH ST
PHILADELPHIA, PA
ZIP 19121
Phone: (267) 315-5124
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LEGACY RESIDENTIAL PROGRAM is a case management in Philadelphia, PA. The provider is an organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. LEGACY RESIDENTIAL PROGRAM NPI is 1003506171. The provider is registered as an organization entity type.

The provider's business location address is:

2156 N 30TH ST
PHILADELPHIA, PA
ZIP 19121-101
Phone: (267) 315-5124
Fax: (267) 324-3106

The provider's authorized official is Ashley Edwards .
The authorized official title is Ceo and has the following contact phone number (215) 397-7823.

The enumeration date for this NPI number is 5/11/2023 and was last updated on 5/11/2023.


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
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessNo
2315P00000XIntermediate Care Facility, Intellectual DisabilitiesNo
3320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
4320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
5320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
6323P00000XPsychiatric Residential Treatment FacilityNo
7324500000XSubstance Abuse Rehabilitation FacilityNo
8251B00000XCase ManagementYes

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
11366151854MEDICAIDDELAWARE
21386342533MEDICAIDPENNSYLVANIA

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: 5/5/2024

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