| Legacy Care Llc | |
|
2914 W Solano Dr S Phoenix AZ 85017-2543 | |
| (480) 349-0813 | |
| Not Available |
| Full Name | Legacy Care Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2914 W Solano Dr S, Phoenix, Arizona |
| Authorized Official Name and Position | Simon Amedai (OWNER) |
| Authorized Official Contact | 4803490813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Care Llc 4327 W Maldonado Rd Laveen AZ 85339-6227 Ph: (480) 349-0813 | Legacy Care Llc 2914 W Solano Dr S Phoenix AZ 85017-2543 Ph: (480) 349-0813 |
| NPI Number | 1639927585 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 05/13/2024 |
| Certification Date | 05/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639927585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 3104A0625X | Assisted Living Facility - Assisted Living, Mental Illness | (* (Not Available)) | Secondary |
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