{
"Npi": {
"NPI": "1083590640",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LEGACY FAMILY ENTERTAINMENT",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "211 PROVIDENCE RD STE 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHESAPEAKE",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23325-4687",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-937-5563",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "211 PROVIDENCE RD STE 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHESAPEAKE",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23325-4687",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-937-5563",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/11/2025",
"LastUpdateDate": "08/12/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOUSE",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "757-937-5770",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385HR2055X",
"TaxonomyName": "Child Mental Illness Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}