MK LEGACY (NPI# 1245742626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245742626 |
| Entity Type | Organization |
| Organization Name | MK LEGACY |
| Practice Address |
422 E Vermijo Ave Ste G16 Colorado Springs CO 80903-3791 |
| Practice Telephone | 7192031892 |
| Mailing Telephone | 7192031892 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | CHARLOTTE MCCLANAHAN (AGENCY DIRECTOR) |
| Authorized Official Telephone | 7192031892 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | MK Legacy, LLC | 422 E. Vermijo Ave., Suite G16, Colorado Springs, CO 80903 |
| Street Address |
422 E VERMIJO AVE STE G16 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80903-3791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235752437 | Lisa Mae Bunch | Behavior Technician | 102 South Tajon St. Ste 1100, Colorado Springs, CO 80903 | 2020-05-21 |
| 1164045407 | Lajanae Davis | Behavior Technician | 102 S. Tajon Street Ste. 1100, Colorado Springs, CO 80903 | 2020-05-21 |
| 1144855321 | Quinn Macdonald | Specialist/Technologist | 1332 N Weber Street, Colorado Springs, CO 80903 | 2020-03-08 |
| 1043784994 | Neuro Peak Performance, LLC | Counselor | 801 N. Weber St Suite 101, Colorado Springs, CO 80903 | 2019-01-14 |
| 1356828297 | Heart of The Phoenix, LLC | Social Worker | 1422 N Hancock Ave Ste 1, Colorado Springs, CO 80903 | 2018-07-24 |
| 1699269290 | Jenevieve Marie Briand | Day Training/Habilitation Specialist | 427 E Colorado Ave Ste 225, Colorado Springs, CO 80903 | 2018-06-18 |
| 1669983292 | Robin Dina Shankman | Massage Therapist | 127 E. Las Animas, Colorado Springs, CO 80903 | 2017-10-23 |
| 1023559804 | Sean Michael Blumahrdt | Specialist/Technologist, Other | 13 South Tejon St, Ste 501, Colorado Springs, CO 80903 | 2017-03-14 |
| 1366980682 | Edge Medical Services | Clinic/Center | 152 West Colorado Ave, Colorado Springs, CO 80903 | 2017-02-07 |
| 1093267890 | Brittany Nicole Holmes | Behavioral Analyst | 938 S Sierra Madre, Colorado Springs, CO 80903 | 2016-10-27 |
| Find all providers in zip 80903 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831753904 | Jeffrey Thomas Lockman | Day Training, Developmentally Disabled Services | 2914 Austin Bluffs Pkwy Ste 100, Colorado Springs, CO 80918-5719 | 2019-04-24 |
| 1861964165 | Theresa A Jordan Dba Trent's Team | Day Training, Developmentally Disabled Services | 3812 E Pikes Peak Ave Ste 205, Colorado Springs, CO 80909-6781 | 2018-12-26 |
| 1679055388 | Craft Care | Day Training, Developmentally Disabled Services | 2049 Legacy Ridge Vw Apt 105, Colorado Springs, CO 80910-4810 | 2018-08-30 |
| 1518462258 | Krzyinc | Day Training, Developmentally Disabled Services | 5049 Ardley Dr, Colorado Springs, CO 80922-2135 | 2018-03-26 |
| 1073031084 | Swift Behavioral, LLC | Day Training, Developmentally Disabled Services | 5895 Walsh Pt Apt 208, Colorado Springs, CO 80919-2043 | 2017-08-30 |
| 1467977496 | Patricia Beatrice Baugh | Day Training, Developmentally Disabled Services | 145 Ely St, Colorado Springs, CO 80911-2123 | 2017-08-10 |
| 1245766187 | Brandie Harrison | Day Training, Developmentally Disabled Services | 1270 Beacon Hill Way, Colorado Springs, CO 80905-8107 | 2017-05-11 |
| 1841737731 | Special Kids Special Families | Day Training, Developmentally Disabled Services | 3450 N Nevada Ave, Colorado Springs, CO 80907-5331 | 2017-01-30 |
| 1821540477 | Melinda L Hanson | Day Training, Developmentally Disabled Services | 20075 Thunder Rd E, Colorado Springs, CO 80908-1110 | 2016-10-31 |
| 1316396526 | Our House Inc. | Day Training, Developmentally Disabled Services | 6750 N Union Blvd, Colorado Springs, CO 80918-6012 | 2016-06-08 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80903 |
Please comment or provide details below to improve the information on MK LEGACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.