Organization Active NPI

Legacy Estates Management, LP

  • Assisted Living Facility
  • Lincoln, NE
National Provider Identifier
1548564552
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
ALF282 Issued in NE
Legal business name
LEGACY ESTATES MANAGEMENT, LP
Practice address
7200 Van Dorn St
Lincoln, NE 68506-3716
Phone
(402) 484-8888
Fax
(402) 484-3859
NPI assigned
Jan 5, 2011
Last updated
Jan 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Authorized official

Name
Mr. Jay Bohlken
Title
Executive Director
Phone
(402) 484-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ALF282 NE Primary

Addresses

Primary practice location

7200 Van Dorn St
Lincoln, NE 68506-3716

Mailing address

7200 Van Dorn St
Lincoln, NE 68506-3716
Phone (402) 484-8888

Other identifiers 1

IdentifierTypeStateIssuer
10025084200MedicaidNE

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D1020744Legacy Estates7200 Van Dorn Street, Lincoln, NE 68506Certificate of waiverDec 30, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1548564552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063716",
            "telephone_number": "402-484-8888",
            "fax_number": "402-484-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 VAN DORN ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063716",
            "telephone_number": "402-484-8888",
            "fax_number": "402-484-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY ESTATES MANAGEMENT, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "BOHLKEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-484-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025084200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.