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General NPI Number Information
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NPI Number | 1649473307
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Entity Type | Organization
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Legal Business Name | OUR LEGACY VENTURES LLC
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4901 FITZHUGH AVE SUITE 201
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City | RICHMOND
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State | VA
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Zip | 23230-3531
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Country | US
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Telephone | 804-644-1076
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Fax | 804-644-4005
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Provider Business Mailing Address
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Address Line | 4901 FITZHUGH AVE SUITE 201
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City | RICHMOND
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State | VA
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Zip | 23230-3531
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Country | US
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Telephone | 804-644-1076
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Fax | 804-644-4005
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. LINWOOD ANTHONY CARTER
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Credential |
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Telephone | 804-644-1076
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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 | HCO-339PC
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License Number State | VA
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