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General NPI Number Information
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NPI Number | 1043175755
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Entity Type | Organization
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Legal Business Name | LEGACY CARE PROVIDERS, LLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 3006 ALBRECHT DR
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City | PROSPECT
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State | KY
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Zip | 40059-8105
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Country | US
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Telephone | 502-396-3545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22736
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City | LOUISVILLE
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State | KY
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Zip | 40252-0736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCUS FORWARD SR.
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Credential |
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Telephone | 502-396-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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