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General NPI Number Information
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NPI Number | 1427412196
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Entity Type | Organization
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Legal Business Name | LEGACY HOME HEALTH CARE & HOSPICE LLC
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 03/08/2019
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Provider Practice Location Address
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Address Line | W156N10952 CATSKILL LN
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City | GERMANTOWN
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State | WI
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Zip | 53022-4215
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Country | US
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Telephone | 262-293-6415
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Fax | 262-437-1350
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Provider Business Mailing Address
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Address Line | PO BOX 572
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City | GERMANTOWN
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State | WI
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Zip | 53022-0572
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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 | ADMINISTRATOR
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Name | SHANELLE SNOWDEN
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Credential |
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Telephone | 262-293-6415
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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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