Organization
THE LEGACY FOUNDATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIP BOUNYASANE (PRESIDENT)
(801) 556-4037
Entity
Organization
Contact information
Practice address
5503 WEST 9000 SOUTH, APT B 201, WEST JORDAN, UT 84081
(801) 556-4037
Mailing address
PO BOX 632, WEST JORDAN, UT 84084-0632
(801) 556-4037
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/31/2025
Last updated
12/31/2025
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