Provider Demographics
NPI:1013246065
Name:LEGACY HEALTHCARE GROUP,INC.
Entity Type:Organization
Organization Name:LEGACY HEALTHCARE GROUP,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BEDE
Authorized Official - Middle Name:AKANWA
Authorized Official - Last Name:EMUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-437-6804
Mailing Address - Street 1:3107 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3612
Mailing Address - Country:US
Mailing Address - Phone:281-437-6804
Mailing Address - Fax:713-559-0361
Practice Address - Street 1:3107 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3612
Practice Address - Country:US
Practice Address - Phone:281-437-6804
Practice Address - Fax:713-559-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health