Provider Demographics
NPI:1689394777
Name:LEGACY HEALTH CARE LLC
Entity Type:Organization
Organization Name:LEGACY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISSET
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIAN ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-530-8298
Mailing Address - Street 1:900 W 49TH ST STE 314
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3489
Mailing Address - Country:US
Mailing Address - Phone:305-530-8298
Mailing Address - Fax:305-530-8466
Practice Address - Street 1:900 W 49TH ST STE 314
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3489
Practice Address - Country:US
Practice Address - Phone:305-530-8298
Practice Address - Fax:305-530-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty