Legacy Place

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

370371 Issued in MN

Legal business name

LEGACY PLACE

Practice address

902 15TH St NE
Sauk Rapids, MN 56379-9605

Phone

(320) 259-7988

NPI assigned

Jan 16, 2015

Organization subpart

No

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

Authorized official

Name

Todd Norman

Title

Owner

Phone

(320) 492-4677

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1255720074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 11TH AVE SE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563041708",
            "telephone_number": "320-492-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 15TH ST NE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563799605",
            "telephone_number": "320-259-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-492-4677"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "370371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Omondi Juma
• Kimberly K Krogstad, D.P.T
• Mamusu Lamin
• Sandra Lynn Landwehr
• Kayla Marie Larkin, LPCC
• Haven Maryanne Licht, RN
• Carlos Angel Lopez Jr.
• Lindsey Lovaas, MS, LPCC, LADC, NCC
• Ulysses J Loyal
• Tracy Annette Ludwig, C.M.T.

• Assisted Living Facility in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.