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General NPI Number Information
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NPI Number | 1265390355
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Entity Type | Organization
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Legal Business Name | LEGACY CARE CENTER LLC
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 304 MULDEE ST
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City | DURHAM
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State | NC
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Zip | 27703-2396
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Country | US
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Telephone | 800-459-2320
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 SEDWICK RD STE 200D
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City | DURHAM
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State | NC
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Zip | 27713-4335
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Country | US
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Telephone | 800-721-1092
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAQUEL MIKELA THOMAS
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Credential |
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Telephone | 336-587-8797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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