Healthcare Provider Details

I. General information

NPI: 1477474666
Provider Name (Legal Business Name): LEGACY 44
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4290 CEDARCROFT CT APT 2B
GREENSBORO NC
27409-9217
US

IV. Provider business mailing address

4290 CEDARCROFT CT APT 2B
GREENSBORO NC
27409-9217
US

V. Phone/Fax

Practice location:
  • Phone: 919-824-8571
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: YAW HARRISON
Title or Position: FOUNDER/EXECUTIVE DIRECTOR
Credential:
Phone: 919-824-8571