Healthcare Provider Details

I. General information

NPI: 1568214922
Provider Name (Legal Business Name): LEGACY HEALTHCARE STAFFING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 NE 52ND ST # 203
OKLAHOMA CITY OK
73105-1814
US

IV. Provider business mailing address

447 CROWN ST
BROOKLYN NY
11225-3119
US

V. Phone/Fax

Practice location:
  • Phone: 405-871-0784
  • Fax:
Mailing address:
  • Phone: 405-871-0784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ASHER SIMPSON
Title or Position: OWNER
Credential:
Phone: 405-871-0784