# LEGACY LIVING CARE

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

## Provider details

- **NPI number:** 1235932088
- **Authorized official:** SHANKIVIA SHANAY DAUGHERTY (ADMINISTRATOR)
- **Authorized official phone:** (404) 644-3072

## Contact information

- **Practice address:** 3561 LEHIGH WAY, DECATUR, GA 30034-5726
- **Practice address phone:** (404) 644-3072
- **Mailing address:** 3561 LEHIGH WAY, DECATUR, GA 30034-5726
- **Mailing address phone:** (404) 644-3072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 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