Trinidad Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23Z790 Issued in CO

Legal business name

TRINIDAD ASSISTED LIVING, LLC

Doing business as

The Legacy at Trinidad

Practice address

33 Legacy LN
Trinidad, CO 81082-9300

Phone

(719) 846-8662

NPI assigned

Nov 13, 2015

Organization subpart

No

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

Authorized official

Name

Mr. David B Beardsley

Title

President

Phone

(423) 596-0169

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Legacy at Trinidad Doing business as

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": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1477927440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "KINGSVILLE",
            "state": "MO",
            "postal_code": "640610023",
            "telephone_number": "423-596-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 LEGACY LN",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810829300",
            "telephone_number": "719-846-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINIDAD ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "BEARDSLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-596-0169",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23Z790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48738336",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT",
            "identifier": "23Z790",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Legacy at Trinidad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinidad Ambulance District
• Trinidad Area Health Association
• Trinidad Area Health Association
• Trinidad Area Health Association
• Trinidad Area Health Association
• Trinidad Autism Awareness
• Trinidad Family Medical Center
• Trinidad Inn Inc
• Trinidad Inn, Inc.
• Trinidad Medical Associates , LLC

• Assisted Living Facility in Trinidad, CO
• Providers in Trinidad, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.