LEGACY HOUSE (NPI# 1285757187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285757187 |
| Entity Type | Organization |
| Organization Name | LEGACY HOUSE |
| Practice Address |
6893 Happy Valley Rd Anderson CA 96007-9526 |
| Mailing Address |
190 Whitmore Ln Ukiah CA 95482-6932 |
| Practice Telephone | 5303659119 |
| Mailing Telephone | 7074670911 |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID I NERVO (OWNER) |
| Authorized Official Telephone | 7074670911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | CA | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LEGACY HOUSE | 770 W Francis St, Roseburg, OR 97471 |
| Colorado Business Entities | Legacy House Ministries, Inc | 10427 W Hampden Ave Unit 15-102, Lakewood, CO 80227 |
| Indiana Business Entities | LEGACY HOUSE OF SPEEDWAY, LLC | 2014 Allison Avenue, Speedway, IN 46224 |
| Colorado Business Entities | Legacy House Productions, LLC | 264 S Jefferson Ave, Louisville, CO 80027 |
| Indiana Business Entities | LEGACY HOUSE PROPERTIES, LLC | 2014 Allison Ave, Speedway, IN 46224 |
| Oregon Corporations, Companies and Business Names | LEGACY HOUSE SUPPORTED LIVING, LLC | 2774 Kincaid St, Eugene, OR 97405 |
| System for Award Management (SAM) Entities | LEGACY HOUSE, INC | 200 W 131st St Apt 10c, New York, NY 10027-2041 |
| Street Address |
6893 HAPPY VALLEY RD |
| City | ANDERSON |
| State | CA |
| Zip Code | 96007-9526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780948497 | Marilee Ruth King | Veterinarian | 3100 W Center St, Anderson, CA 96007 | 2012-06-27 |
| 1881821064 | William Martin Reuss Iv | Dentist | 1930 North Barney St., Anderson, CA 96007 | 2009-06-16 |
| 1063676898 | Adriana Elia Vazquez | Licensed Vocational Nurse | 7175 Eastsidee Rd, Anderson, CA 96007 | 2008-07-10 |
| 1730211103 | Danene Renee Mercill | Dentist | 2817 Childress Rd, Anderson, CA 96007 | 2007-03-12 |
| 1750457388 | Debra Marie Wright | Family Medicine | 2830 East Street, Anderson, CA 96007 | 2006-11-27 |
| 1346315538 | Susan Frances Capella | Occupational Therapist | 3300 Franklin St, Anderson, CA 96007 | 2006-11-22 |
| 1205917127 | Walmart Stores, Inc. | Technician/Technologist | 5000 Rhonda Road, Anderson, CA 96007 | 2006-10-18 |
| 1063527372 | Steven Edward Ahrens | Dentist | 1901 Barney Rd, Anderson, CA 96007 | 2006-08-20 |
| 1255340568 | Paul C Davainis | Family Medicine | 2965 East St, Anderson, CA 96007 | 2006-08-05 |
| 1700137882 | Roberta Ann Samples | Registered Nurse | 2830 East St, Anderson, CA 96007 | 2012-09-28 |
| Find all providers in zip 96007 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407915309 | New Foundations Children & Family Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 2300 Standridge Rd, Anderson, SC 29625-3211 | 2006-12-06 |
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|---|---|---|---|---|
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| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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| 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.