Organization
LEGACY ADULT FAMILY HOMES
Active
Other names
Legacy Adult Family Homes
Organization subpart
No
Provider details
NPI number
Authorized official
TONI DALLAS (ENTITY REP)
(509) 637-7745
Entity
Organization
Contact information
Practice address
404 N CONWAY ST, KENNEWICK, WA 99336-3047
(509) 637-7745
(509) 627-7745
Mailing address
404 N CONWAY ST, KENNEWICK, WA 99336-3047
(509) 627-7745
(509) 783-7945
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2201521
—
WA
Enumeration date
02/04/2022
Last updated
02/04/2022
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