LEGACY VILLAGE HQ, LLC – NPI #1275225310
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

LEGACY VILLAGE HQ, LLC is a substance abuse rehabilitation facility located in BOISE, ID. NPPES has assigned the NPI number 1275225310 to LEGACY VILLAGE HQ, LLC on May 25, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LEGACY VILLAGE HQ, LLC below.

NPI Profile for
LEGACY VILLAGE HQ, LLC

NPI Number
1275225310
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LEGACY VILLAGE HQ, LLC
Primary location
800 W MAIN ST STE 1460
BOISE, ID 83702-5983
Phone: (800) 997-6977 Fax: (661) 489-0573
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DENNIS FARMER
CHIEF EXECUTIVE OFFICER
Phone: (800) 997-6977
Updated
Certification Date
May 25, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.