LEGACY CARE HOME NPI 1659717692

NPI Information

NPI: 1659717692
Provider Name: LEGACY CARE HOME
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 24D1085477

Address:
14900 CROWN DR
MINNETONKA, MN
ZIP 55345
Phone: (612) 597-3153
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LEGACY CARE HOME is an assisted living facility in Minnetonka, MN. 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. LEGACY CARE HOME NPI is 1659717692. The provider is registered as an organization entity type.

The provider's business location address is:

14900 CROWN DR
MINNETONKA, MN
ZIP 55345-603
Phone: (612) 597-3153

The provider's authorized official is Michelle Nash .
The authorized official title is Owner/executive Direct and has the following contact phone number (612) 597-3153.

The CLIA number assigned to this NPI record is 24D1085477 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/17/2013 and was last updated on 5/17/2013.

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		CLASS F	MINNESOTA	Yes

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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