Provider Demographics
NPI:1588670384
Name:LEGACY MEDHEALTH SERVICES, INC
Entity type:Organization
Organization Name:LEGACY MEDHEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REMEDIOS
Authorized Official - Middle Name:T
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-781-0242
Mailing Address - Street 1:4500 LEGACY DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2179
Mailing Address - Country:US
Mailing Address - Phone:972-781-0242
Mailing Address - Fax:972-781-0234
Practice Address - Street 1:5000 LEGACY DRIVE
Practice Address - Street 2:SUITE 350
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3100
Practice Address - Country:US
Practice Address - Phone:972-781-0242
Practice Address - Fax:972-781-0234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007887251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX368150OtherJCAHO
TX007887OtherTEXAS STATE LIC
TX45D0968851OtherCLIA
TX007887OtherTEXAS STATE LIC