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General NPI Number Information
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NPI Number | 1346240850
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Entity Type | Organization
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Legal Business Name | LEGACY HOMECARE PLUS UNLIMITED, INC.
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 1840 N HACIENDA BLVD #11
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City | LA PUENTE
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State | CA
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Zip | 91744-1143
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Country | US
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Telephone | 626-918-2868
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Fax | 626-918-6878
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Provider Business Mailing Address
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Address Line | 1840 N HACIENDA BLVD #11
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City | LA PUENTE
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State | CA
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Zip | 91744-1143
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Country | US
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Telephone | 626-918-2868
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Fax | 626-918-6878
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MISS JOJETTE SUGUITAN
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Credential | RN
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Telephone | 626-918-2868
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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 | 058142
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License Number State | CA
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