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Organization
LEGACY LIVING CARE OF MICHIGAN LLC
Active
Organization
LEGACY LIVING CARE OF MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANKIVIA DAUGHERTY (CEO)
(404) 989-8279
Entity
Organization
Contact information
Practice address
475 BURGUNDY CT, STONE MOUNTAIN, GA 30087-4713
(404) 989-8279
Mailing address
475 BURGUNDY CT, STONE MOUNTAIN, GA 30087-4713
(404) 989-8279
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
314000000X
Skilled Nursing Facility
—
NULL
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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