| Legacy Wellness Llc | |
|
263 S Fork Loop Stuart VA 24171-2659 | |
| (276) 790-4649 | |
| Not Available |
| Full Name | Legacy Wellness Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 263 S Fork Loop, Stuart, Virginia |
| Authorized Official Name and Position | Shannon Walker Huffman (CEO) |
| Authorized Official Contact | 2767904649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Wellness Llc 263 S Fork Loop Stuart VA 24171-2659 Ph: (276) 790-4649 | Legacy Wellness Llc 263 S Fork Loop Stuart VA 24171-2659 Ph: (276) 790-4649 |
| NPI Number | 1710567763 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710567763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Secondary |
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