Healthcare Provider Details

I. General information

NPI: 1689253148
Provider Name (Legal Business Name): LEGACY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 GREENBRIER CIR STE 208
CHESAPEAKE VA
23320-2642
US

IV. Provider business mailing address

816 GREENBRIER CIR STE 208
CHESAPEAKE VA
23320-2642
US

V. Phone/Fax

Practice location:
  • Phone: 757-227-4047
  • Fax: 757-227-4109
Mailing address:
  • Phone: 757-227-4047
  • Fax: 757-227-4109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DENNIS LACHENEY
Title or Position: GENERAL MANAGER
Credential:
Phone: 804-481-0009