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Organization

TRINIDAD ASSISTED LIVING, LLC

Active
Other names
The Legacy at Trinidad
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID B BEARDSLEY (PRESIDENT)
(423) 596-0169
Entity
Organization

Contact information

Practice address
33 LEGACY LN, TRINIDAD, CO 81082-9300
(719) 846-8662
Mailing address
PO BOX 23, KINGSVILLE, MO 64061-0023
(423) 596-0169

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23Z790
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23Z790
COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
CO
05
48738336
CO
Enumeration date
11/13/2015
Last updated
11/13/2015
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