Active NPI
Legacy Sobriety and Recovery LLC
- Assisted Living Facility (Mental Illness)
- Milwaukee, WI
National Provider Identifier
1174490536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility (Mental Illness)
- Legal business name
- LEGACY SOBRIETY AND RECOVERY LLC
- Practice address
- 2810 W Kilbourn Ave Apt 3
Milwaukee, WI 53208-3501 - Phone
- (414) 309-3213
- Fax
- (414) 309-3213
- NPI assigned
- Oct 21, 2025
- Last updated
- Oct 24, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Davida Clifton
- Title
- Owner
- Phone
- (414) 309-3213
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | NU | ||
| Assisted Living Facility (Mental Illness) | 3104A0625X | NU | Primary | |
| Adult Care Home Facility | 311ZA0620X | NU | ||
| Respite Care | 385H00000X | NU | ||
| In Home Supportive Care Agency | 253Z00000X | NU |
Addresses
Primary practice location
2810 W Kilbourn Ave Apt 3
Milwaukee, WI 53208-3501
Mailing address
2810 W Kilbourn Ave Apt 3
Milwaukee, WI 53208-3501
Phone (414) 309-3213
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chore Provider
- Milwaukee, WI
- NPI 1689541872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761004800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761264000000",
"number": "1174490536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 W KILBOURN AVE APT 3",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083501",
"telephone_number": "414-309-3213",
"fax_number": "414-309-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 W KILBOURN AVE APT 3",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083501",
"telephone_number": "414-309-3213",
"fax_number": "414-309-3213"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY SOBRIETY AND RECOVERY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-21",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A",
"authorized_official_last_name": "CLIFTON",
"authorized_official_first_name": "DAVIDA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "414-309-3213"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.