MEDICARE: LEGACY HOSPICE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1730054487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY HOSPICE SERVICES LLC

Provider Business Mailing Address
First Line	:	2002 CROSS CUT DR
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-4792
Country	:	US
Telephone Number	:	972-807-0713
Fax Number	:	972-807-0807

Provider Business Practice Location Address
First Line	:	2002 CROSS CUT DR
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-4792
Country	:	US
Telephone Number	:	214-709-2875
Fax Number	:	972-807-0807

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LEWIS
Credential	:
Telephone Number	:	972-807-0713

Provider Enumeration Date	:	10/10/2025
Last Update Date	:	12/08/2025

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