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LEGACY HOUSE OF SOUTH JORDAN
NPI 1124177233
Assisted Living Facility in South Jordan, UT

Active since January 09, 2007CLIA 46D2199705 · Waiver
1517 TEMPLE LN, SOUTH JORDAN, UT 84095(801) 254-0373(801) 254-0250 Get Directions Write a Review

NPPES record last updated: July 11, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Legacy House Of South Jordan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY HOUSE OF SOUTH JORDAN (NPI 1124177233) is a healthcare organization registered as an assisted living facility in South Jordan, Utah and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 9, 2026 and lists Jaunice Kay Minor, Executive Assistant, as its authorized official.

NPPES Registry Identity

NPI1124177233
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameJORDAN HOUSE ASSISTED LIVING, LC
Location Address1517 TEMPLE LNSouth Jordan, UT 84095-2415
Mailing Address1517 Temple LnSouth Jordan, UT 84095-2415 · (801) 254-0373 · Fax (801) 254-0250
Phone(801) 254-0373
Fax(801) 254-0250
Organization SubpartNo
Authorized OfficialJaunice Kay MinorExecutive Assistant · (801) 269-0700
Enumeration DateJanuary 9, 2007
Last NPPES UpdateJuly 11, 2008
✔ NPI 1124177233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in UT · ALII17895
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1517 TEMPLE LN, South Jordan, UT 84095
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Other Names 1

Doing Business AsLegacy House Of South Jordan

Other Identifiers 1

OtherALII17895UT · State License Number

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2199705

Jordan House Assisted Living, Lc · South Jordan, UT
Active · expires Nov 9, 2026
CLIA Number46D2199705
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 10, 2024
Certificate Expiration DateNovember 9, 2026
Laboratory DirectorTami Ford
Laboratory Phone(801) 254-0373
Laboratory LocationJordan House Assisted Living, Lc1517 W Temple Lane, South Jordan, UT 84095
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan House Assisted Living, Lc's NPI number?

The NPI number for Jordan House Assisted Living, Lc is 1124177233. It was assigned to this organization in the NPPES registry on January 9, 2007. The provider is doing business as Legacy House Of South Jordan.

Where is Jordan House Assisted Living, Lc located?

Jordan House Assisted Living, Lc is located at 1517 Temple Ln, South Jordan, UT 84095. The listed phone number is (801) 254-0373.

What is Jordan House Assisted Living, Lc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Jordan House Assisted Living, Lc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2199705) is associated with this NPI, valid through November 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jordan House Assisted Living, Lc was last updated on July 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.