Provider Demographics
NPI:1003044835
Name:LEGACY HOSPICE LLC
Entity Type:Organization
Organization Name:LEGACY HOSPICE LLC
Other - Org Name:NEW CENTURY HOSPICE OF DENVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP LICENSURE
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-814-2013
Mailing Address - Street 1:PO BOX 4060
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-4060
Mailing Address - Country:US
Mailing Address - Phone:704-664-2876
Mailing Address - Fax:704-664-1306
Practice Address - Street 1:380 PERRY ST STE 210
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2485
Practice Address - Country:US
Practice Address - Phone:303-660-6107
Practice Address - Fax:888-660-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO42280281Medicaid
17J598OtherLICENSE
061570Medicare Oscar/Certification