Organization
LEGACY PERSONAL CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELITA JIMENEZ-MARTINEZ (OWNER)
(208) 369-6467
Entity
Organization
Contact information
Practice address
120 9TH AVE S STE 110, NAMPA, ID 83651-3824
(208) 369-6467
(208) 463-4516
Mailing address
PO BOX 127, NAMPA, ID 83653-0127
(208) 369-6467
(208) 463-4516
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0011664
—
ID
Enumeration date
01/05/2026
Last updated
01/05/2026
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