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General NPI Number Information
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NPI Number | 1407515687
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Entity Type | Organization
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Legal Business Name | LEGACY U HEALTH CARE CONSULTING & TRAINING CENTER
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 3900 MERTON DR STE 250
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City | RALEIGH
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State | NC
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Zip | 27609-6636
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Country | US
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Telephone | 252-258-5093
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Fax | 919-964-3105
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Provider Business Mailing Address
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Address Line | 3900 MERTON DR STE 250
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City | RALEIGH
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State | NC
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Zip | 27609-6636
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Country | US
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Telephone | 252-258-5093
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Fax | 919-964-3105
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SHONICA HARRIS JONES
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Credential | RN
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Telephone | 191-951-6922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare 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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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