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General NPI Number Information
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NPI Number | 1174483135
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Entity Type | Organization
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Legal Business Name | LEGACY CARE HOSPICE LLC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 402 BLACK HILLS LN SW STE B
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City | OLYMPIA
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State | WA
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Zip | 98502-8146
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Country | US
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Telephone | 360-968-5550
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Fax | 360-968-5551
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Provider Business Mailing Address
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Address Line | 402 BLACK HILLS LN SW STE B
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City | OLYMPIA
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State | WA
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Zip | 98502-8146
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Country | US
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Telephone | 360-968-5550
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Fax | 360-968-5551
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Authorized Official
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Title or Position | COO
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Name | JUDITH I GREY
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Credential |
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Telephone | 201-919-4905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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