MEDICARE: LEGACY LIVING CENTERS

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
1	314000000X	Skilled Nursing Facility	113559	TX

General Provider Information

NPI Number	:	1598752495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY LIVING CENTERS

Provider Business Mailing Address
First Line	:	4900 E BERRY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-4314
Country	:	US
Telephone Number	:	817-531-3707
Fax Number	:	817-536-1648

Provider Business Practice Location Address
First Line	:	4900 E BERRY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-4314
Country	:	US
Telephone Number	:	817-531-3707
Fax Number	:	817-536-1648

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. MARIE LAWSON
Credential	:
Telephone Number	:	817-531-3707

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1588725592 — FWM HEALTHCARE, LLC DBA FT. WORTH MANOR
Practice Location Address:

4900 E BERRY ST
FT WORTH, TX
76105-4314

Practice Phone: 817-531-3707
Practice Fax:

1518418128 — ROBERT MARRIOTT MEDICAL CORP
Practice Location Address:

4900 E BERRY ST
FORT WORTH, TX
76105-4314

Practice Phone: 877-878-3289
Practice Fax: 877-817-3227

1023778420 — ADVANTAGE SURGICAL AND WOUND CARE TEXAS PA
Practice Location Address:

4900 E BERRY ST
FORT WORTH, TX
76105-4314

Practice Phone: 877-878-3289
Practice Fax: 877-817-3227

1184165557 — ANDREA KINKEADE
Practice Location Address:

521 E FORT WORTH DR
BROKEN ARROW, OK
74012-4314

Practice Phone: 918-574-1004
Practice Fax:

1417641341 — BRITTANY ELDRIDGE
Practice Location Address:

3212 SAGESTONE DR APT 4314
FORT WORTH, TX
76177-1904

Practice Phone: 281-702-4133
Practice Fax:

1124770797 — ANCHAL BAHL
Practice Location Address:

432 SF ST
LAKE WORTH, FL
33460-4314

Practice Phone: 954-309-1249
Practice Fax:

Directions to “LEGACY LIVING CENTERS ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.