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LEGEND AT JEFFERSON'S GARDEN
NPI 1982938072
Residential Treatment Facility, Physical Disabilities in Edmond, OK

Active since September 23, 2009CLIA 37D2192125 · Waiver
15401 N PENNSYLVANIA AVE, EDMOND, OK 73013(405) 715-1717(405) 715-9017 Get Directions Write a Review

NPPES record last updated: September 23, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legend At Jefferson's Garden NPPES

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

LEGEND AT JEFFERSON'S GARDEN (NPI 1982938072) is a healthcare organization registered as a residential treatment facility, physical disabilities in Edmond, Oklahoma and active in the NPI registry since September 2009. The organization holds a CLIA Waiver certificate valid through September 3, 2026 and lists Nelda Randall, Director, as its authorized official.

NPPES Registry Identity

NPI1982938072
Entity TypeOrganization
Primary Taxonomy320700000X
Legal Business NameLEGEND AT JEFFERSON'S GARDEN
Location Address15401 N PENNSYLVANIA AVEEdmond, OK 73013
Mailing Address15401 N Pennsylvania AveEdmond, OK 73013 · (405) 715-1717 · Fax (405) 715-9017
Phone(405) 715-1717
Fax(405) 715-9017
Organization SubpartNo
Authorized OfficialNelda RandallDirector · (405) 715-1717
Enumeration DateSeptember 23, 2009
✔ NPI 1982938072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Physical DisabilitiesResidential Treatment Facilities
Taxonomy Code320700000X
License✔ Licensed in OK · AL5517-5517
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
15401 N PENNSYLVANIA AVE, Edmond, OK 73013
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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 37D2192125

Legend At Jefferson's Garden Pennsylvania Alf, LLC · Edmond, OK
Active · expires Sep 3, 2026
CLIA Number37D2192125
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 4, 2024
Certificate Expiration DateSeptember 3, 2026
Laboratory DirectorRiley Loving
Laboratory Phone(405) 715-1717
Laboratory LocationLegend At Jefferson's Garden Pennsylvania Alf, LLC15401 N Pennsylvania Ave, Edmond, OK 73013
CLIA data matches this NPI record on: Address 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 Legend At Jefferson's Garden's NPI number?

The NPI number for Legend At Jefferson's Garden is 1982938072. It was assigned to this organization in the NPPES registry on September 23, 2009.

Where is Legend At Jefferson's Garden located?

Legend At Jefferson's Garden is located at 15401 N Pennsylvania Ave, Edmond, OK 73013. The listed phone number is (405) 715-1717.

What is Legend At Jefferson's Garden's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Physical Disabilities with taxonomy code 320700000X.

Does Legend At Jefferson's Garden hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2192125) is associated with this NPI, valid through September 3, 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 Legend At Jefferson's Garden was last updated on September 23, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.