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General NPI Number Information
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NPI Number | 1326905167
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Entity Type | Organization
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Legal Business Name | LEGACY PERSONAL CARE SERVICES, LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 120 9TH AVE S STE 110
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City | NAMPA
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State | ID
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Zip | 83651-3824
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Country | US
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Telephone | 208-369-6467
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Fax | 208-463-4516
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | NAMPA
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State | ID
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Zip | 83653-0127
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Country | US
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Telephone | 208-369-6467
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Fax | 208-463-4516
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Authorized Official
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Title or Position | OWNER
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Name | ANGELITA JIMENEZ-MARTINEZ
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Credential |
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Telephone | 208-369-6467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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