Provider Demographics
NPI:1619447075
Name:LEGACY SENIOR CARE, LLC
Entity Type:Organization
Organization Name:LEGACY SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKING
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:615-400-3471
Mailing Address - Street 1:1314 GARTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2751
Mailing Address - Country:US
Mailing Address - Phone:615-560-1525
Mailing Address - Fax:
Practice Address - Street 1:1314 GARTLAND AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-2751
Practice Address - Country:US
Practice Address - Phone:615-560-1525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty