Provider Demographics
NPI:1932593118
Name:LEGACY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:LEGACY HEALTH SERVICES INC
Other - Org Name:LEGACY HOSPICE AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-342-7005
Mailing Address - Street 1:13721 ROSWELL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5463
Mailing Address - Country:US
Mailing Address - Phone:909-342-7005
Mailing Address - Fax:
Practice Address - Street 1:13721 ROSWELL AVE STE A
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5463
Practice Address - Country:US
Practice Address - Phone:909-342-7005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based