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Organization
LEGACY LIVING CARE
Active
Organization
LEGACY LIVING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANKIVIA SHANAY DAUGHERTY (ADMINISTRATOR)
(404) 644-3072
Entity
Organization
Contact information
Practice address
3561 LEHIGH WAY, DECATUR, GA 30034-5726
(404) 644-3072
Mailing address
3561 LEHIGH WAY, DECATUR, GA 30034-5726
(404) 644-3072
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
251F00000X
Home Infusion Agency
—
NULL
251G00000X
Community Based Hospice Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QA0600X
Adult Day Care Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QM3000X
Medically Fragile Infants and Children Day Care
—
NULL
314000000X
Skilled Nursing Facility
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
03/28/2025
Last updated
04/09/2025
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