# LIVE A LEGACY VENT CARE HOME, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508219692
- **Authorized official:** DIANA NICORICI RN (OWNER)
- **Authorized official phone:** (360) 828-1873

## Contact information

- **Practice address:** 216 NE 151ST AVE, VANCOUVER, WA 98684-8171
- **Practice address phone:** (360) 828-1873
- **Mailing address:** PO BOX 874045, VANCOUVER, WA 98687-4045
- **Mailing address phone:** (360) 828-1873
- **Mailing address fax:** (360) 838-8838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | 753086 | WA | Yes |

## Other

- **Enumeration date:** 07/13/2016
- **Last updated:** 07/13/2016