| Legacy Kids Llc | |
|
1213 Aviator Ln S Tustin CA 92782-1701 | |
| (949) 412-5939 | |
| Not Available |
| Full Name | Legacy Kids Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1213 Aviator Ln S, Tustin, California |
| Authorized Official Name and Position | Misty M Wei (OWNER/DIRECTOR) |
| Authorized Official Contact | 9494125939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Kids Llc 1213 Aviator Ln S Tustin CA 92782-1701 Ph: (949) 412-5939 | Legacy Kids Llc 1213 Aviator Ln S Tustin CA 92782-1701 Ph: (949) 412-5939 |
| NPI Number | 1679352892 |
|---|---|
| Provider Enumeration Date | 09/26/2023 |
| Last Update Date | 03/24/2024 |
| Certification Date | 03/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679352892 | NPI | - | NPPES |
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