Healthcare Provider Details

I. General information

NPI: 1639074933
Provider Name (Legal Business Name): LEGACY HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 NICHOLS DR
TAUNTON MA
02780-4373
US

IV. Provider business mailing address

PO BOX 103
RAYNHAM MA
02767-0103
US

V. Phone/Fax

Practice location:
  • Phone: 508-639-0905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUNISE PAUL
Title or Position: OWNER
Credential:
Phone: 617-792-3564