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NPI Code Detail

MEDICARE: LEGACY HEALTHCARE SERVICES INC

MEDICARE: LEGACY HEALTHCARE SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist
2225X00000XOccupational Therapist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1023684370
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY HEALTHCARE SERVICES INC
Provider Business Mailing Address
First Line : 110 HORIZON DR STE 310
Second Line :
City : RALEIGH
State : NC
Zip : 27615-4926
Country : US
Telephone Number : 919-424-5080
Fax Number :
Provider Business Practice Location Address
First Line : 650 S DODSON RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-7015
Country : US
Telephone Number : 855-239-3467
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. WILLIAM GIL WILSON JR.
Credential :
Telephone Number : 919-424-5080
Provider Enumeration Date : 05/27/2021
Last Update Date : 01/22/2026

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Directions to “LEGACY HEALTHCARE SERVICES INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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