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Organization
A LIVING LEGACY
Active
Organization
A LIVING LEGACY
Active
Other names
A Living Legacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA WILSON (OWNER)
(706) 289-1107
Entity
Organization
Contact information
Practice address
3509 AMBASSADOR DR, COLUMBUS, GA 31907-2304
(706) 289-1107
Mailing address
3509 AMBASSADOR DR, COLUMBUS, GA 31907-2304
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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