# LEGACY HEALTHCARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063806784
- **Authorized official:** KELLI ANNE PITMAN OT (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (704) 435-0108

## Contact information

- **Practice address:** 3100 SPRING FOREST RD, RALEIGH, NC 27616-2880
- **Practice address phone:** (704) 435-0108
- **Mailing address:** 3100 SPRING FOREST RD, RALEIGH, NC 27616-2880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100000000000009 | NC | Yes |

## Other

- **Enumeration date:** 03/19/2015
- **Last updated:** 03/19/2015