=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477907608
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEGEND TOTAL HEALTH CARE SOLUTIONS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/13/2016
-----------------------------------------------------
Last Update Date | 04/13/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2265 COUNTY ROAD 111
-----------------------------------------------------
City | GARWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77442-4021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-791-8039
-----------------------------------------------------
Fax | 832-742-5277
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2265 COUNTY ROAD 111
-----------------------------------------------------
City | GARWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77442-4021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-791-8039
-----------------------------------------------------
Fax | 832-742-5277
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | RODRICK CARTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-791-8039
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------