MEDICARE: LEGACY CARE SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1881524676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	36 COPLEY RD UPPR
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 COPLEY RD UPPR
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2512
Country	:	US
Telephone Number	:	267-770-9320
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MOHAMMED MAYAH
Credential	:
Telephone Number	:	267-770-9320

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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