LEGACY HOUSE LLC (NPI# 1871640144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871640144 |
| Entity Type | Organization |
| Organization Name | LEGACY HOUSE LLC |
| Practice Address |
207 E Salem Ave Indianola IA 50125-2621 |
| Mailing Address |
7740 Larabee St Indianola IA 50125-7101 |
| Practice Telephone | 5159615245 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2013-01-30 |
| Authorized Official Name | MRS. CINDY J BRUMMER (ADMINISTRATOR) |
| Authorized Official Telephone | 5159615245 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
910498 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0896761 | 05 |
| Street Address |
207 E SALEM AVE |
| City | INDIANOLA |
| State | IA |
| Zip Code | 50125-2621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316583107 | Mach3 Physical Therapy and Wellness | Clinic/Center | 938 East Hillcrest Ave, Suite A, Indianola, IA 50125 | 2019-11-27 |
| 1023667995 | Bonnie Dufault | Technician | 2402 West Euclid Ave, Indiana, IA 50125 | 2019-09-04 |
| 1407307499 | Traci Rudolf-hanrahan | Social Worker | 310 North Buxton Street, Indianola, IA 50125 | 2016-10-14 |
| 1548544216 | Long Term Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 126 N Howard St, Suite 102, Indianola, IA 50125 | 2011-09-29 |
| 1629272836 | Michael James Hadden | Specialist/Technologist | Simpson College, 701 North C Street, Indianola, IA 50125 | 2007-06-12 |
| 1245440221 | Indianola Ia Assisted Living | Assisted Living Facility | 608 South 15th St., Indianola, IA 50125 | 2007-05-22 |
| 1689769432 | Michele Tingle | Emergency Medicine | 9128 87th Ln, Indianola, IA 50125 | 2006-10-04 |
| 1538114764 | Sue Marie Peterson | Specialist/Technologist | 1507 N 1st St, Indianola, IA 50125 | 2006-05-24 |
| 1124079934 | Jonathan P Anderson | Optometrist | 225 W Ashland, Ste 1, Indianola, IA 50125 | 2006-05-15 |
| 1528025533 | Jessica A Espenmiller | Occupational Therapist | 1507 North 1st St, Indianola, IA 50125 | 2006-04-26 |
| Find all providers in zip 50125 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1164964003 | Creative Image Personal Care Service LLC | Custodial Care Facility | 503 Highway 82 E, Indianola, MS 38751-2317 | 2016-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1952510281 | Emeritus Properties II, Inc | Custodial Care Facility | 136 36th Avenue Sw, Cedar Rapids, IA 52404-4638 | 2007-05-22 |
| 1518086420 | Diamond Life Health Care, Inc. | Custodial Care Facility | 4912 Barnes City Rd, Montezuma, IA 50171-8544 | 2007-03-29 |
| 1750412672 | Proffitt's Residential | Custodial Care Facility | 615 West Washington St, Centerville, IA 52544-1623 | 2007-03-09 |
| 1790842615 | Keokuk Area Group Home | Custodial Care Facility | 317 High St, Keokuk, IA 52632-5939 | 2007-01-02 |
| 1063578359 | Gbgb Lc Dba Briarwood Care Center | Custodial Care Facility | 416 S Clark St, Maquoketa, IA 52060-3226 | 2006-12-29 |
| 1285797415 | Comprehensive Systems, Inc | Custodial Care Facility | 818 N 7th St, Osage, IA 50461-1360 | 2006-12-19 |
| 1679636740 | Comprehensive Systems, Inc. | Custodial Care Facility | 841 W Main St, New Hampton, IA 50659-1005 | 2006-12-19 |
| 1780747915 | Comprehensive Systems, Inc | Custodial Care Facility | 702 Elm Street, Elma, IA 50628 | 2006-12-19 |
| 1144383464 | Comprehensive Systems, Inc | Custodial Care Facility | 695 S Illinois Ave, Mason City, IA 50401-5405 | 2006-12-18 |
| 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.