LEGEND AT JEFFERSON'S GARDEN NPI 1982938072

NPI Information

  • NPI: 1982938072
  • Provider Name: LEGEND AT JEFFERSON'S GARDEN
  • Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
  • Entity Type: Organization
  • CLIA Number: 37D2192125
  • Address: 15401 N PENNSYLVANIA AVE
    EDMOND, OK
    ZIP 73013
  • Phone: (405) 715-1717

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NPI Details

LEGEND AT JEFFERSON'S GARDEN is a residential treatment facility physical disabilities in Edmond, OK. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. LEGEND AT JEFFERSON'S GARDEN NPI is 1982938072. The provider is registered as an organization entity type.

The provider's business location address is:

15401 N PENNSYLVANIA AVE
EDMOND, OK
ZIP 73013
Phone: (405) 715-1717
Fax: (405) 715-9017

The provider's authorized official is Nelda Randall .
The authorized official title is Director and has the following contact phone number (405) 715-1717.

The CLIA number assigned to this NPI record is 37D2192125 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2009 and was last updated on 9/23/2009.

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
1320700000XResidential Treatment Facility, Physical DisabilitiesAL5517-5517OKLAHOMAYes

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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