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General NPI Number Information
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NPI Number | 1679231187
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Entity Type | Organization
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Legal Business Name | LEGACY ALLIED HEALTH LLC
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 43 WARREN DR APT 22
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City | LITTLE ROCK
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State | AR
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Zip | 72209-7602
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Country | US
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Telephone | 501-414-2590
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 191904
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City | LITTLE ROCK
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State | AR
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Zip | 72219-1904
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Country | US
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Telephone | 501-414-2590
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | SHERIKA QUINTEL LAMB
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Credential |
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Telephone | 501-590-2962
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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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