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General NPI Number Information
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NPI Number | 1083582332
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Entity Type | Organization
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Legal Business Name | LEGACY HOME HEALTHCARE CORP
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 365 SAND BAY DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-8906
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Country | US
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Telephone | 678-355-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 365 SAND BAY DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-8906
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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 | ADMINISTRATOR
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Name | UGOCHUKWU JUDE MBIONWU
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Credential |
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Telephone | 678-355-8718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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