Healthcare Provider Details

I. General information

NPI: 1922456953
Provider Name (Legal Business Name): LEGEND HEALTH CARE RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 DUNLAP ST N STE 400M
SAINT PAUL MN
55104-4235
US

IV. Provider business mailing address

393 DUNLAP ST N STE 400M
SAINT PAUL MN
55104-4235
US

V. Phone/Fax

Practice location:
  • Phone: 651-330-9267
  • Fax: 651-348-8369
Mailing address:
  • Phone: 651-330-9267
  • Fax: 651-348-8369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number377068
License Number StateMN

VIII. Authorized Official

Name: MR. AHMED MOHAMED ANSHUR
Title or Position: MANAGING DIRECTOR
Credential: CEO
Phone: 651-706-9933