| Legacy Human Services, Inc. | |
|
941 U.s. 158 Vance Adult Group Home Henderson NC 27537 | |
| (252) 492-7778 | |
| (252) 438-6720 |
| Full Name | Legacy Human Services, Inc. |
|---|---|
| Speciality | Custodial Care Facility - Adult Care Home |
| Location | 941 U.s. 158, Henderson, North Carolina |
| Authorized Official Name and Position | Jacinta Johnson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2524386700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Human Services, Inc. Po Box 88 Henderson NC 27536-0088 Ph: (252) 438-6700 | Legacy Human Services, Inc. 941 U.s. 158 Vance Adult Group Home Henderson NC 27537 Ph: (252) 492-7778 |
| NPI Number | 1811166507 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 09/10/2021 |
| Certification Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811166507 | NPI | - | NPPES |
| 7805490 | Medicaid | NC |
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