Legacy Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

LEGACY CHARTER SCHOOL

Practice address

2422 12TH Ave Rd
#225
Nampa, ID 83686-6300

Phone

(208) 466-7952

NPI assigned

Jun 6, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Celeste Blackburn

Title

Operations Manager

Phone

(208) 922-9300

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1154615243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 12TH AVE RD",
            "address_2": "#225",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 12TH AVE RD",
            "address_2": "#225",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866300",
            "telephone_number": "208-466-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "208-922-9300"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Hiu Tung Lee
• Karin Elaine Lee
• Nicole Anne Bodenstab Lee, LMSW
• Paul Lee, PA
• Shawn D Lee, D.M.D.
• Legacy Personal Care Services, LLC
• Legacy RHS, LLC
• Angel Legare, PA-C
• Terry John Legg, LPC
• Daniel Paul Lemmon

• Local Education Agency (LEA) in Nampa, ID
• Providers in Nampa, ID by specialty
• Local Education Agency (LEA) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.