Provider Demographics
NPI:1366011017
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:MANAGER, LICENSING & CERTIFICATION
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 1:655 BRAWLEY SCHOOL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9601
Mailing Address - Country:US
Mailing Address - Phone:704-662-0416
Mailing Address - Fax:
Practice Address - Street 1:425 S CHERRY ST STE 750
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1272
Practice Address - Country:US
Practice Address - Phone:303-753-2329
Practice Address - Fax:303-753-2342
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-17
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000159444Medicaid