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General NPI Number Information
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NPI Number | 1356808125
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Entity Type | Organization
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Legal Business Name | LEGACY TERRACE WEST SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 119 MAIN ST E
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City | SLEEPY EYE
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State | MN
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Zip | 56085-1352
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Country | US
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Telephone | 507-227-2798
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Fax | 507-794-3003
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Provider Business Mailing Address
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Address Line | 119 MAIN ST E
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City | SLEEPY EYE
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State | MN
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Zip | 56085-1352
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Country | US
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Telephone | 507-227-2798
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Fax | 507-794-3003
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Authorized Official
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Title or Position | RN SUPERVISOR
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Name | LEANN DOMEIER
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Credential | RN
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Telephone | 507-227-2798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State | NULL
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