Provider Demographics
NPI:1194529826
Name:LEGACY HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:LEGACY HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-478-7030
Mailing Address - Street 1:7384 STATE ROAD 21, KEYSTONE HEIGHTS, FL 32656
Mailing Address - Street 2:
Mailing Address - City:KEYSTONE HEIGHTS
Mailing Address - State:FL
Mailing Address - Zip Code:32656
Mailing Address - Country:US
Mailing Address - Phone:352-478-7030
Mailing Address - Fax:
Practice Address - Street 1:7384 STATE ROAD 21, KEYSTONE HEIGHTS, FL 32656
Practice Address - Street 2:
Practice Address - City:KEYSTONE HEIGHTS
Practice Address - State:FL
Practice Address - Zip Code:32656
Practice Address - Country:US
Practice Address - Phone:352-478-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY HOME HEALTH CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)