| The Legacy House Pllc | |
|
2615 W 23rd St Panama City FL 32405-2339 | |
| (850) 331-0134 | |
| (850) 306-6721 |
| Full Name | The Legacy House Pllc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2615 W 23rd St, Panama City, Florida |
| Authorized Official Name and Position | Denise Folsom (LMHC) |
| Authorized Official Contact | 8503310134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Legacy House Pllc 2615 W 23rd St Panama City FL 32405-2339 Ph: (850) 331-0134 | The Legacy House Pllc 2615 W 23rd St Panama City FL 32405-2339 Ph: (850) 331-0134 |
| NPI Number | 1932734845 |
|---|---|
| Provider Enumeration Date | 03/11/2020 |
| Last Update Date | 08/07/2020 |
| Certification Date | 08/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932734845 | NPI | - | NPPES |
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