Provider Demographics
NPI:1578274353
Name:LEGACY SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:LEGACY SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:UZOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-341-0113
Mailing Address - Street 1:2851 S PARKER RD STE 1-0340
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2736
Mailing Address - Country:US
Mailing Address - Phone:720-341-0113
Mailing Address - Fax:
Practice Address - Street 1:2851 S PARKER RD STE 1-0340
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2736
Practice Address - Country:US
Practice Address - Phone:720-341-0113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care