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General NPI Number Information
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NPI Number | 1922456953
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Entity Type | Organization
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Legal Business Name | LEGEND HEALTH CARE RESOURCES, LLC
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 393 NORTH DUNLAP STREET SUITE 400C
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City | SAINT PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 651-330-9267
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Fax | 651-348-8369
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Provider Business Mailing Address
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Address Line | 393 NORTH DUNLAP STREET SUITE 400C
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City | SAINT PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 651-330-9267
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Fax | 651-348-8369
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. AHMED MOHAMED ANSHUR
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Credential | CEO
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Telephone | 651-706-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 377068
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License Number State | MN
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