| Em Legacy Llc | |
|
2605 72nd Ave E 221 Ellenton FL 34222-7000 | |
| (941) 545-9630 | |
| Not Available |
| Full Name | Em Legacy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2605 72nd Ave E, Ellenton, Florida |
| Authorized Official Name and Position | Erin M Porter (MNGR DIRECTOR) |
| Authorized Official Contact | 9415459630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Em Legacy Llc 2605 72nd Ave E 221 Ellenton FL 34222-7000 Ph: (941) 545-9630 | Em Legacy Llc 2605 72nd Ave E 221 Ellenton FL 34222-7000 Ph: (941) 545-9630 |
| NPI Number | 1386056984 |
|---|---|
| Provider Enumeration Date | 05/30/2014 |
| Last Update Date | 05/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386056984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11139 (Florida) | Primary |
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