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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LEGACY CARE HOME
NPI 1174452122
Assisted Living Facility in Golden Valley, MN

Active since May 15, 2026CLIA Certified · 3 labs
5230 CIRCLE DOWN, GOLDEN VALLEY, MN 55416(612) 964-8376(763) 201-5991 Get Directions Write a Review

NPPES record added: May 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Care Home NPPES

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

LEGACY CARE HOME (NPI 1174452122) is a healthcare organization registered as an assisted living facility in Golden Valley, Minnesota and active in the NPI registry since May 2026. The organization holds 3 active CLIA laboratory certificates and lists Stephanie Fryer, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1174452122
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLEGACY CARE HOME
Location Address5230 CIRCLE DOWNGolden Valley, MN 55416-1308
Mailing Address5230 Circle DownGolden Valley, MN 55416-1308 · (612) 964-8376 · Fax (763) 201-5991
Phone(612) 964-8376
Fax(763) 201-5991
Organization SubpartNo
Authorized OfficialStephanie FryerDirector Of Operations · (763) 300-7875
Enumeration DateMay 15, 2026
NPPES CertifiedMay 15, 2026
✔ NPI 1174452122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
5230 CIRCLE DOWN, Golden Valley, MN 55416
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Other Identifiers 1

OtherA933458900MN · Umpi

CLIA Laboratory Certificates CMS CLIA 3

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 24D2163774

Legacy Care Home · Golden Valley, MN
Active · expires Mar 20, 2027
CLIA Number24D2163774
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 21, 2025
Certificate Expiration DateMarch 20, 2027
Laboratory DirectorCatalina J. Hemp
Laboratory Phone(612) 310-5597
Laboratory LocationLegacy Care Home5230 Circle Down, Golden Valley, MN 55416
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2273787

Legacy Care Home · Minnetonka, MN
Active · expires Dec 19, 2026
CLIA Number24D2273787
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorCatalina J. Hemp
Laboratory Phone(612) 964-8376
Laboratory LocationLegacy Care Home5531 Eden Prairie Road, Minnetonka, MN 55345
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2273789

Legacy Care Home · Minnetonka, MN
Active · expires Dec 19, 2026
CLIA Number24D2273789
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorCatalina J. Hemp
Laboratory Phone(612) 964-8376
Laboratory LocationLegacy Care Home14814 Crown Drive, Minnetonka, MN 55345
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 Legacy Care Home's NPI number?

The NPI number for Legacy Care Home is 1174452122. It was assigned to this organization in the NPPES registry on May 15, 2026.

Where is Legacy Care Home located?

Legacy Care Home is located at 5230 Circle Down, Golden Valley, MN 55416. The listed phone number is (612) 964-8376.

What is Legacy Care Home's specialty?

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

Does Legacy Care Home hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Legacy Care Home was last updated on May 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.