Carson Legacy LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CARSON LEGACY LLC

Practice address

2423 S Georgia Ave
Caldwell, ID 83605-4477

Phone

(208) 455-1788

NPI assigned

Jan 22, 2025

Organization subpart

Yes

Parent organization

CARSON LEGACY LLCAs reported in NPPES

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

Authorized official

Name

Paige Carson

Title

Owner

Phone

(267) 229-3694

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peak Recovery Doing business as

Part of

Carson Legacy LLC

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1346052875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 S GEORGIA AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054477",
            "telephone_number": "208-455-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 S GEORGIA AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054477",
            "telephone_number": "208-455-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARSON LEGACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARSON LEGACY LLC",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-229-3694"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861963340",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carepoint Health Emergency Medicine Idaho, PLLC
• Carepoint Health Idaho, PLLC
• Karen Elizabeth Carloy, NP-C
• Lisa Ann Carriere, M.S., SLP
• Heather Louise Carrizales, LMSW, ADC
• Sharon E. Carswell, M.D.
• Amy Allison Cash Haggerty, RN
• Hijiriko Castleman, LPC
• Elizabeth Castro
• Darci Caywood, RDMS

• Substance Use Disorder Rehabilitation Clinic/Center in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.