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Organization

LEGACY HOUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID I NERVO (OWNER)
(707) 467-0911
Entity
Organization

Contact information

Practice address
6893 HAPPY VALLEY RD, ANDERSON, CA 96007-9526
(530) 365-9119
Mailing address
190 WHITMORE LN, UKIAH, CA 95482-6932
(707) 467-0911

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CA

Other

Enumeration date
04/08/2007
Last updated
08/22/2020
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