MEDICARE: THE LEGACY LIMITED PARTNERSHIP, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	ALF174	NE

General Provider Information

NPI Number	:	1114221066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LEGACY LIMITED PARTNERSHIP, LTD

Provider Business Mailing Address
First Line	:	5600 PIONEERS BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5172
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 PIONEERS BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5172
Country	:	US
Telephone Number	:	402-436-3000
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TJ NEIHAUS
Credential	:
Telephone Number	:	404-436-3000

Provider Enumeration Date	:	01/07/2011
Last Update Date	:	01/07/2011

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