National Provider Identifier Database

CARSON LEGACY LLC
Rehabilitation, Substance Use Disorder


Contact Information

CARSON LEGACY LLC
2423 S GEORGIA AVE
CALDWELL, ID83605-4477
Phone: 208-455-1788
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for CARSON LEGACY LLC

NPI Number 1346052875
Legal business name
LBN
CARSON LEGACY LLC
Authorized official PAIGE CARSON - (OWNER)
Entity Organization
Organization subpart Yes
Enumeration date 01/22/2025
Last updated 01/22/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • ID Medicaid: 1861963340

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for CARSON LEGACY LLC

There are currently no reviews for CARSON LEGACY LLC


NPIdb - Home
v2.201