Provider Demographics
NPI:1396068649
Name:LEGACIES, LLC
Entity type:Organization
Organization Name:LEGACIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:NATZKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-884-5191
Mailing Address - Street 1:37478 COUNTY ROAD 70
Mailing Address - Street 2:
Mailing Address - City:ZUMBRO FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55991-5031
Mailing Address - Country:US
Mailing Address - Phone:507-753-2883
Mailing Address - Fax:
Practice Address - Street 1:37478 COUNTY ROAD 70
Practice Address - Street 2:
Practice Address - City:ZUMBRO FALLS
Practice Address - State:MN
Practice Address - Zip Code:55991-5031
Practice Address - Country:US
Practice Address - Phone:507-753-2883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health