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LEGENDS PARK ASSISTED LIVING COMMUNITY
NPI 1154458354
Assisted Living Facility in Coeur D Alene, ID

Active since February 27, 2007
1820 W GOLF COURSE RD, COEUR D ALENE, ID 83815(208) 666-9900(208) 765-6587 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Legends Park Assisted Living Community NPPES

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

LEGENDS PARK ASSISTED LIVING COMMUNITY (NPI 1154458354) is a healthcare organization registered as an assisted living facility in Coeur D Alene, Idaho and active in the NPI registry since February 2007. The organization lists Gregory J Vislocky, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1154458354
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLEGENDS PARK LLC
Location Address1820 W GOLF COURSE RDCoeur D Alene, ID 83815-1627
Mailing Address7700 Ne Parkway Dr, Suite 300Vancouver, WA 98662-6648 · (360) 735-7155 · Fax (360) 735-9416
Phone(208) 666-9900
Fax(208) 765-6587
Organization SubpartNo
Authorized OfficialGregory J VislockyManaging Member · (360) 735-7155
Enumeration DateFebruary 27, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1154458354 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 ID · RC 548
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.
1820 W GOLF COURSE RD, Coeur D Alene, ID 83815
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Other Names 1

Doing Business AsLegends Park Assisted Living Community

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 13D2011402

Legends Park Assisted Living · Coeur D Alene, ID
Expired · Aug 16, 2026
CLIA Number13D2011402
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 17, 2024
Certificate Expiration DateAugust 16, 2026
Laboratory DirectorShayla M. Archer
Laboratory Phone(208) 666-9900
Laboratory LocationLegends Park Assisted Living1820 N Legends Parkway, Coeur D Alene, ID 83815
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 Legends Park LLC's NPI number?

The NPI number for Legends Park LLC is 1154458354. It was assigned to this organization in the NPPES registry on February 27, 2007. The provider is doing business as Legends Park Assisted Living Community.

Where is Legends Park LLC located?

Legends Park LLC is located at 1820 W Golf Course Rd, Coeur D Alene, ID 83815. The listed phone number is (208) 666-9900.

What is Legends Park LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Legends Park LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.