National Provider Identifier Database

LEGACY VILLAGE HEALTHCARE LLC
Skilled Nursing Facility

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.


Contact Information

LEGACY VILLAGE HEALTHCARE LLC
5472 S 3200 W
TAYLORSVILLE, UT84129-7804
Phone: 801-269-0700
Fax: 801-269-1512
Website:
Specialty Taxonomy Code
* Skilled Nursing Facility 314000000X
Alzheimer Center /Dementia Center/Dementia Special Care Unit 311500000X

* Indicates primary specialty

NPI Profile & details for LEGACY VILLAGE HEALTHCARE LLC

NPI Number 1881866499
Legal business name
LBN
LEGACY VILLAGE HEALTHCARE LLC
Authorized official PAUL FAIRHOLM - (MANAGING MEMBER)
Entity Organization
Organization subpart Yes
Enumeration date 03/24/2008
Last updated 04/22/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: TO BE DETERMINED
  • UT License #: TO BE DETERMINED
  • UT Medicaid: 113661303001
  • UT Medicaid: 800008673001
  • UT Medicaid: 870520717001
  • UT Medicaid: 870638970001

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.

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