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General NPI Number Information
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NPI Number | 1578238291
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Entity Type | Organization
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Legal Business Name | LEGACY CARE STAFFING, LLC
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 3024 MEMORIAL DR SE STE D
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City | ATLANTA
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State | GA
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Zip | 30317-3517
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Country | US
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Telephone | 404-795-1455
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Fax | 866-654-6692
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Provider Business Mailing Address
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Address Line | 3024 MEMORIAL DR SE STE D
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City | ATLANTA
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State | GA
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Zip | 30317-3517
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Country | US
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Telephone | 404-795-1455
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Fax | 866-654-6692
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TIAWON DOWLING
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Credential |
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Telephone | 678-698-0112
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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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