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Organization
LEGACY SKILL NURSING L.L.C.
Active
Organization
LEGACY SKILL NURSING L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAVIE LOPEZ (PRESIDENT)
(787) 607-2574
Entity
Organization
Contact information
Practice address
908 CALLE VICTORIA, BARIO TEJAS, HUMACAO, PR 00791
(787) 719-7878
Mailing address
PO BOX 246, LAS PIEDRAS, PR 00771-0246
(787) 719-7878
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
417856
STATE DEPARTMENT
PR
Enumeration date
03/05/2019
Last updated
03/05/2019
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