Organization
LEGACY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE FRYER LALD (DIRECTOR OF OPERATIONS)
(763) 300-7875
Entity
Organization
Contact information
Practice address
14814 CROWN DR, MINNETONKA, MN 55345-3601
(612) 964-8376
(763) 201-5991
Mailing address
14814 CROWN DR, MINNETONKA, MN 55345-3601
(612) 964-8376
(763) 201-5991
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M998147500
UMPI
MN
Enumeration date
05/15/2026
Last updated
05/15/2026
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