Provider Demographics
NPI:1821759523
Name:FAMILY LEGACY HOSPICE LLC
Entity Type:Organization
Organization Name:FAMILY LEGACY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-853-0060
Mailing Address - Street 1:9000 TESORO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6132
Mailing Address - Country:US
Mailing Address - Phone:210-853-0060
Mailing Address - Fax:
Practice Address - Street 1:9000 TESORO DR STE 100E-1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6140
Practice Address - Country:US
Practice Address - Phone:210-853-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based