Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Lodge at Jackson Hole, Inc

Organization Assisted Living Facility · NPI 1760927453

Legacy Lodge at Jackson Hole, Inc is an Assisted Living Facility in Jackson, Wyoming. Licensed in Wyoming. Registered with an NPI since 2017.

Licensed in
WY
In the registry since
2017
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3000 W Big Trail Dr
Jackson, WY 83001-9138
Phone: (307) 734-0500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X (WY)

Record details

NPI number1760927453
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Harnisch — Vp Of Finance · (402) 753-6101
NPI enumeratedJanuary 4, 2017
Last updated in NPPESJanuary 4, 2017
Mailing address2230 N Somers Ave, Fremont, NE 68025-2515

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