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General NPI Number Information
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NPI Number | 1376338335
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Entity Type | Organization
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Legal Business Name | STEWART LEGACY HEALTHCARE SERVICES
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/12/2025
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Provider Practice Location Address
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Address Line | 4539 N 22ND ST STE B
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 702-859-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST STE B
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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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 | CEO
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Name | ARMANI RAQUAN HOUSTON-GRAY
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Credential |
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Telephone | 702-859-7797
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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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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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