Provider Demographics
NPI:1568128577
Name:LASTING LEGACY HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:LASTING LEGACY HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-562-1987
Mailing Address - Street 1:1807 PALM WARBLER LN
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-7961
Mailing Address - Country:US
Mailing Address - Phone:813-562-4998
Mailing Address - Fax:
Practice Address - Street 1:137 S PEBBLE BEACH BLVD STE 202H
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5708
Practice Address - Country:US
Practice Address - Phone:813-562-4998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-14
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health