LEGACY LIVING NPI 1063925303

NPI Information

  • NPI: 1063925303
  • Provider Name: LEGACY LIVING
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Address: 445 E 10TH ST
    BAXTER SPRINGS, KS
    ZIP 66713
  • Phone: (620) 856-2756

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NPI Details

LEGACY LIVING is an adult care home custodial care facility in Baxter Springs, KS. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. LEGACY LIVING NPI is 1063925303. The provider is registered as an organization entity type.

The provider's business location address is:

445 E 10TH ST
BAXTER SPRINGS, KS
ZIP 66713-614
Phone: (620) 856-2756

The provider's authorized official is Randy Duke Dotson .
The authorized official title is Owner/operator and has the following contact phone number (620) 387-0005.

The enumeration date for this NPI number is 11/8/2017 and was last updated on 11/8/2017.

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
1311ZA0620XCustodial Care FacilityAdult Care HomeB011004KANSASYes

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
1B011004OTHERKANSASHOME PLUS
2818OTHERKANSASADULT CARE OPERATOR

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: 11/21/2025

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