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General NPI Number Information
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NPI Number | 1003516170
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Entity Type | Organization
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Legal Business Name | LEGACY'S HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1700 E ASH ST STE 302
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City | GOLDSBORO
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State | NC
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Zip | 27530-4097
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Country | US
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Telephone | 919-429-6070
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Fax | 919-429-6071
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Provider Business Mailing Address
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Address Line | 1700 E ASH ST STE 302
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City | GOLDSBORO
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State | NC
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Zip | 27530-4097
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Country | US
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Telephone | 919-429-6070
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Fax | 919-429-6071
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Authorized Official
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Title or Position | OWNER
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Name | JOI PEACOCK
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Credential |
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Telephone | 919-223-8743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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