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General NPI Number Information
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NPI Number | 1700725603
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Entity Type | Organization
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Legal Business Name | LEGACY 4 HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 1241 SEVILLE LOOP
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City | GRANTS
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State | NM
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Zip | 87020-3112
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Country | US
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Telephone | 505-290-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 SEVILLE LOOP
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City | GRANTS
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State | NM
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Zip | 87020-3112
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Country | US
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Telephone | 505-290-7626
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Fax |
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Authorized Official
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Title or Position | DON
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Name | NICOLE M CHAVEZ
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Credential | REGISTERED NURSE
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Telephone | 505-240-7229
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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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