Healthcare Provider Details

I. General information

NPI: 1619447075
Provider Name (Legal Business Name): LEGACY SENIOR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 GARTLAND AVE
NASHVILLE TN
37206-2751
US

IV. Provider business mailing address

1314 GARTLAND AVE
NASHVILLE TN
37206-2751
US

V. Phone/Fax

Practice location:
  • Phone: 615-560-1525
  • Fax:
Mailing address:
  • Phone: 615-560-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA HOSKING
Title or Position: PRESIDENT
Credential: OT
Phone: 615-400-3471