Organization · Type 2 NPI

Legacy Village Outpatient Id, LLC

Substance Abuse Rehabilitation Facility · Boise, ID

NPI number 1225721707 Active

Practice location

800 W Main St Ste 1460
Boise, ID 83702-5983

Call (800) 997-6977 Map

Fax (661) 489-0573

Specialties and licenses

TaxonomyCodeLicense
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801XNone listed
Substance Abuse Rehabilitation Facility Primary 324500000XNone listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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About NPI 1225721707

Legacy Village Outpatient Id, LLC's National Provider Identifier is 1225721707, issued on May 31, 2023. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Boise, ID. The record was last updated on May 31, 2023.