LEGENDS PARK LLC (NPI# 1154458354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154458354 |
| Entity Type | Organization |
| Organization Name | LEGENDS PARK LLC |
| Other Organization Name | LEGENDS PARK ASSISTED LIVING COMMUNITY |
| Practice Address |
1820 W Golf Course Rd Coeur D Alene ID 83815-1627 |
| Mailing Address |
7700 Ne Parkway Dr Suite 300 Vancouver WA 98662-6648 |
| Practice Telephone | 2086669900 |
| Practice Fax Number | 2087656587 |
| Mailing Telephone | 3607357155 |
| Mailing Fax Number | 3607359416 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GREGORY J VISLOCKY (MANAGING MEMBER) |
| Authorized Official Telephone | 3607357155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | RC 548 | ID | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Legends Park Assisted Living Community | Doing Business As Name - Organization |
| Street Address |
1820 W GOLF COURSE RD |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83815-1627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133163 | Christine Lee Stanton | Speech-Language Pathologist | 3825 N. Blalock Drive, Coeur D'alene, ID 83815 | 2016-05-26 |
| 1578921961 | Kayla Wearne | Speech-Language Pathologist | 917 W Canfield Avenue, Coeur D'alene, ID 83815 | 2016-02-01 |
| 1770954794 | William Strong | Speech-Language Pathologist | 3902 Broken Arrow Rd, Coeur D Alene, ID 83815 | 2015-10-16 |
| 1235517079 | Denny Bordeaux | Emergency Medical Technician, Paramedic | 7294 Downing Lane, Coeur D Alene, ID 83815 | 2015-05-13 |
| 1689075657 | Barbara Campbell | Pharmacist | W 201 Neider Rd., Coeur D'alene, ID 83815 | 2014-09-10 |
| 1710313671 | Sean Cooper | Pharmacist | W. 201 Neider Rd., Coeur D' Alene, ID 83815 | 2013-09-23 |
| 1275871329 | Lake City Dental | Dentist | 6176 Government Way, Coeur D'alene, ID 83815 | 2013-01-24 |
| 1881972701 | A Better Personal Care Inc | In Home Supportive Care | 3115 N Government Way Ste 2, Coeur D'alene, ID 83815 | 2011-07-26 |
| 1013206895 | Robert Sperry | Pharmacist | 41650 W Maricopacg Hwy., Maricopa, AZ 83815 | 2011-04-01 |
| 1629304670 | Marciea W. Buckley | Social Worker | 109 Harrison Ave, Coeur D' Alene, ID 83815 | 2009-10-27 |
| Find all providers in zip 83815 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174149991 | Rsl Renaissance, LLC | Assisted Living Facility | 2772 W Avante Loop, Coeur D Alene, ID 83815-0333 | 2020-06-17 |
| 1851544084 | Beehive Homes of North Idaho | Assisted Living Facility | 2100 E Sherman Ave, Coeur D Alene, ID 83814-5335 | 2008-10-31 |
| 1609088525 | Emeritus Corporation | Assisted Living Facility | 205 E Anton Ave, Coeur D Alene, ID 83815-3721 | 2007-05-04 |
| 1053746511 | Pacifica Sherman LLC | Assisted Living Facility | 2100 E Sherman Ave, Coeur D Alene, ID 83814-5335 | 2013-09-03 |
| 1326473877 | Pacifica L 44 LLC | Assisted Living Facility | 840 E Dalton Ave, Coeur D Alene, ID 83815-9338 | 2013-09-03 |
| 1164869079 | Encore Senior Living, LLC | Assisted Living Facility | 840 E Dalton Ave, Coeur D Alene, ID 83815-9338 | 2013-05-31 |
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|---|---|---|---|---|
| 1407462906 | Etosha Assisted Living, Inc | Assisted Living Facility | 243 N 300 E, Rupert, ID 83350-9491 | 2020-09-20 |
| 1548886963 | Diamond View Care Properties, LLC | Assisted Living Facility | 3570 E Amity Rd, Meridian, ID 83642-7014 | 2020-06-22 |
| 1619593068 | Frontier Management, LLC | Assisted Living Facility | 10250 W Smoke Ranch Dr, Boise, ID 83709-1467 | 2020-06-22 |
| 1891319141 | Grace At Caldwell LLC | Assisted Living Facility | 518 N 21st Ave, Caldwell, ID 83605-4368 | 2020-06-02 |
| 1790309045 | Grace At Fairview Lakes LLC | Assisted Living Facility | 1960 N Lakes Pl, Meridian, ID 83646-5939 | 2020-06-02 |
| 1164046413 | Grace Memory Care At State Street LLC | Assisted Living Facility | 9779 W State St, Boise, ID 83714-1638 | 2020-06-02 |
| 1356965693 | Grace At State Street LLC | Assisted Living Facility | 9995 W State St, Boise, ID 83714-1636 | 2020-06-02 |
| 1336763689 | Grace LLC | Assisted Living Facility | 1610 Sunnyridge Rd, Nampa, ID 83686-7401 | 2020-06-02 |
| 1447874797 | Grace At Englefield Green LLC | Assisted Living Facility | 250 S Allumbaugh Way, Boise, ID 83709-5624 | 2020-06-02 |
| 1760002869 | New Beginnings Residential Care Facility LLC | Assisted Living Facility | 2105 Avocet Dr, Ammon, ID 83406-6606 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83815 |
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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.