MEDICARE: LEGACY HEIRS CONSUMER 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861349060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY HEIRS CONSUMER SERVICES INC

Provider Business Mailing Address
First Line	:	1088 RHONDA RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-2532
Country	:	US
Telephone Number	:	904-667-1692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1839 LANE AVE S STE 202
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-1260
Country	:	US
Telephone Number	:	904-667-1692
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISS DESTINY IMARI REYNOLDS
Credential	:
Telephone Number	:	904-667-1692

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “LEGACY HEIRS CONSUMER SERVICES INC ” Practice Location

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