Legacy Village For Rehabilitation & Memory Care

LBN: Legacy Village Healthcare Llc
Legacy Village For Rehabilitation & Memory Care is an health care organization with primary practice located at 5472 S 3200 W , Taylorsville UT 84129-7804. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center), Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Legacy Village Healthcare Llc can be contacted via phone (801) 269-0700, or through Fairholm, Paul C via phone (801) 269-0700.

Contact Information

Primary practice address
5472 S 3200 W Taylorsville UT 84129-7804
Phone: (801) 269-0700
Fax: (801) 269-1512
Website:
Map and Directions
Authorized official contact:
Name: Fairholm, Paul C
Phone: (801) 269-0700

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X TO BE DETERMINED Utah
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X TO BE DETERMINED Utah

Profile Details

NPI number 1881866499
LBN Legal business name Legacy Village Healthcare Llc
DBA Doing business as Legacy Village For Rehabilitation & Memory Care
Authorized official Fairholm, Paul C
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 24th, 2008
Last updated Apr 22nd, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881866499 NPPES
Utah MEDICAID 800008673001
Utah MEDICAID 113661303001
Utah MEDICAID 870520717001
Utah MEDICAID 870638970001

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