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General NPI Number Information
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NPI Number | 1639152689
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Entity Type | Organization
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Legal Business Name | LEGACY HOSPICE, LLC
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 107 W HOYT DR STE 101C
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City | LONGVIEW
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State | TX
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Zip | 75601-3614
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Country | US
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Telephone | 903-667-1566
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Fax | 903-509-5971
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Provider Business Mailing Address
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Address Line | 6770 OLD JACKSONVILLE HWY STE 102A
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City | TYLER
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State | TX
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Zip | 75703-0576
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Country | US
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Telephone | 903-509-3015
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Fax | 903-509-5971
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Authorized Official
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Title or Position | SECRETARY
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Name | KATRINA DAWN LANIER
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Credential |
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Telephone | 903-932-1852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 008563
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License Number State | TX
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