Provider Demographics
NPI:1659626596
Name:LEGACY HOME CARE, INC.
Entity Type:Organization
Organization Name:LEGACY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-312-7834
Mailing Address - Street 1:630 N MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4423
Mailing Address - Country:US
Mailing Address - Phone:407-539-2488
Mailing Address - Fax:407-539-2408
Practice Address - Street 1:602 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8078
Practice Address - Country:US
Practice Address - Phone:407-312-7834
Practice Address - Fax:407-539-2408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health