Provider Demographics
NPI:1437728516
Name:THE LEGACY WELLNESS GROUP, LLC
Entity Type:Organization
Organization Name:THE LEGACY WELLNESS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAJSHEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-300-9876
Mailing Address - Street 1:254 COURT AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-2361
Mailing Address - Country:US
Mailing Address - Phone:901-300-9876
Mailing Address - Fax:
Practice Address - Street 1:254 COURT AVE STE 310
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-2361
Practice Address - Country:US
Practice Address - Phone:901-300-9876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty