Legacy Village Outpatient Id, Llc

LBN: Legacy Village Outpatient Id, Llc
Legacy Village Outpatient Id, Llc is an health care organization with primary practice located at 800 W Main St Ste 1460 , Boise ID 83702-5983. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Substance Abuse Rehabilitation Facility is the primary health care specialty. Legacy Village Outpatient Id, Llc can be contacted via phone (800) 997-6977, or through Farmer, Dennis Scott via phone (800) 997-6977.

Contact Information

Primary practice address
800 W Main St Ste 1460 Boise ID 83702-5983
Phone: (800) 997-6977
Fax: (661) 489-0573
Website:
Map and Directions
Authorized official contact:
Name: Farmer, Dennis Scott
Phone: (800) 997-6977

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1225721707
LBN Legal business name Legacy Village Outpatient Id, Llc
DBA Doing business as
Authorized official Farmer, Dennis Scott
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2023
Last updated May 31st, 2023 - about 2 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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