LEGACY HEALTHCARE SERVICES NPI 1699131573

NPI Information

  • NPI: 1699131573
  • Provider Name: LEGACY HEALTHCARE SERVICES
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Other Name: THE FOUNTAINS OF WEST COUNTY
  • Address: 15822 CLAYTON RD
    ELLISVILLE, MO
    ZIP 63011
  • Phone: (636) 220-1681

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NPI Details

LEGACY HEALTHCARE SERVICES is a clinic center in Ellisville, MO. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). LEGACY HEALTHCARE SERVICES NPI is 1699131573. The provider is registered as an organization entity type.
The provider Other Name Is The Fountains Of West County.

The provider's business location address is:

15822 CLAYTON RD
ELLISVILLE, MO
ZIP 63011-212
Phone: (636) 220-1681
Fax: (314) 200-4636

The provider's authorized official is Kelly Ann Fiala .
The authorized official title is Ot/rehab Director and has the following contact phone number (636) 448-2881.

The enumeration date for this NPI number is 1/8/2016 and was last updated on 1/8/2016.

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
1261Q00000XClinic/Center2005028265MISSOURIYes

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
12005028265MEDICARE NSC

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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