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Legacy Village Outpatient Id, Llc
Substance Abuse Rehabilitation Facility in Boise, Idaho
NPI 1225721707

Legacy Village Outpatient Id, Llc is a Substance Abuse Rehabilitation Facility based in Boise, ID. Legacy Village Outpatient Id, Llc practices in Boise, ID. The NPI Number for Legacy Village Outpatient Id, Llc is 1225721707 and holds a License No. (Idaho).

The current practice location address for Legacy Village Outpatient Id, Llc is 800 W Main St Ste 1460, Boise, ID and can be reached out via phone at 800-997-6977 and via fax at 661-489-0573.

Location: 800 W Main St Ste 1460, Boise, ID, 83702-5983
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225721707
Provider Name
Legacy Village Outpatient Id, Llc
Credential
Provider Entity Type
Organization
Address
800 W Main St Ste 1460, Boise, ID, 83702-5983
Phone Number
800-997-6977
Fax Number
661-489-0573
Provider Enumeration Date
05/31/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
800 W Main St Ste 1460
City
Boise
State
Idaho
Zip
83702-5983
Phone Number
800-997-6977
Fax Number
661-489-0573
person
Provider Business Mailing Address Details
Address
800 W Main St Ste 1460
City
Boise
State
Idaho
Zip
83702-5983
Phone Number
800-997-6977
Fax Number
661-489-0573
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
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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