MEDICARE: LEGACY HOME CARE & COMMUNITY SERVICES, LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1639024375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY HOME CARE & COMMUNITY SERVICES, LLC

Provider Business Mailing Address
First Line	:	9809 MARBLE HILL DR
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4926
Country	:	US
Telephone Number	:	804-502-9095
Fax Number	:

Provider Business Practice Location Address
First Line	:	9809 MARBLE HILL DR
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23238-4926
Country	:	US
Telephone Number	:	804-502-9095
Fax Number	:

Authorized Official
Title or Position	:	CEO, OWNER/OPERATOR
Name	:	FLORENCE IRENE JOHNSON
Credential	:
Telephone Number	:	804-502-9095

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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