Provider Demographics
NPI:1013148758
Name:A LEGACY OF HOME HEALTH CARE SERVICES AND HOSPICE LLC.
Entity type:Organization
Organization Name:A LEGACY OF HOME HEALTH CARE SERVICES AND HOSPICE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWENDER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STIGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-831-4801
Mailing Address - Street 1:PO BOX 7468
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-7468
Mailing Address - Country:US
Mailing Address - Phone:903-831-4801
Mailing Address - Fax:903-831-4801
Practice Address - Street 1:115 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-2732
Practice Address - Country:US
Practice Address - Phone:903-244-6768
Practice Address - Fax:903-831-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care