LEGACY VILLAGE, LLC (NPI# 1760012801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760012801 |
| Entity Type | Organization |
| Organization Name | LEGACY VILLAGE, LLC |
| Practice Address |
2024 Oregon St Bakersfield CA 93305-5010 |
| Mailing Address |
1603 California Ave Ste 107 Bakersfield CA 93304-1346 |
| Practice Telephone | 6618462745 |
| Mailing Telephone | 3102720811 |
| Mailing Fax Number | 6614890573 |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |
| Authorized Official Name | MR. DENNIS SCOTT FARMER (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6618462745 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEGACY VILLAGE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Oregon Street Recovery Center II | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295185841 | Legacy Village, LLC | Substance Abuse Rehabilitation Facility | 1620 Oregon St, Bakersfield, CA 93305-4851 | 2016-06-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LEGACY VILLAGE, LLC | 800 Ne Tenney Rd # 110-2, Vancouver, WA 98685-2831 |
| Street Address |
2024 OREGON ST |
| City | BAKERSFIELD |
| State | CA |
| Zip Code | 93305-5010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972112712 | County of Kern | Clinic/Center | 316 Kentucky, Bakersfield, CA 93305 | 2020-07-28 |
| 1003434440 | Centennial Hospice and Palliative Care Inc. | Hospice Care, Community Based | 3016 Union Ave, Ste. C, Bakersfield, CA 93305 | 2020-07-13 |
| 1396377875 | Telecare Corporation | Clinic/Center | 316 Kentuky St, Bakersfield, CA 93305 | 2020-02-12 |
| 1235772054 | Universal Healthcare Services, Inc. | Specialist | 2123 Niles St, Bakersfield, CA 93305 | 2019-10-24 |
| 1447741632 | Kern County Probation Department | Military Health Care Provider | 2005 Ridge Road, Bakersfield, CA 93305 | 2018-05-23 |
| 1164871091 | Luis Gomez | Case Manager/Care Coordinator | 1415 Truxtun Avenue, Bakersfield, CA 93305 | 2016-06-10 |
| 1659747327 | Orchid Home Health Inc. | Home Health | 3016 Union Avenue, Bakersfield, CA 93305 | 2015-08-18 |
| 1407260540 | Tracy Corbett | Counselor | 1932 Jessie Street, Bakersfield, CA 93305 | 2014-06-17 |
| 1982948030 | Kern Medical Center | General Acute Care Hospital | 1420 H Street, Bakersfield, CA 93305 | 2012-11-15 |
| 1124371935 | Bethany Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1600 E Truxtun Ave., Bakersfield, CA 93305 | 2012-10-17 |
| Find all providers in zip 93305 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205025970 | Seven Folds | Substance Abuse Rehabilitation Facility | 201 4th St Ste 702, Bakersfield, CA 93304-2346 | 2007-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275620 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 80 W Nicasio, San Geronimo, CA 94963 | 2020-11-05 |
| 1013518042 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1208 Via Aracena, Camarillo, CA 93010-7440 | 2020-11-05 |
| 1609477645 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1850 Calle Alberca, Camarillo, CA 93010-1811 | 2020-11-05 |
| 1467053736 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 615 Bugeia Ln, Novato, CA 94945-1517 | 2020-11-04 |
| 1376144642 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 100 Avocado Pl, Camarillo, CA 93010-8467 | 2020-11-04 |
| 1285235556 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 7210 Johnston Rd, Pleasanton, CA 94588-9466 | 2020-11-04 |
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| 1598376816 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 6868 Cold Springs Rd, Penngrove, CA 94951-9722 | 2020-08-11 |
| 1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | BAKERSFIELD |
| Zip Code | 93305 |
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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.