# LEGACY LIFELINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifeline Legacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538036041
- **Authorized official:** KIA BULLOCK (CEO)
- **Authorized official phone:** (317) 998-5309

## Contact information

- **Practice address:** 7230 ARBUCKLE CMNS STE 111, BROWNSBURG, IN 46112-1792
- **Practice address phone:** (219) 902-7508
- **Mailing address:** 7230 ARBUCKLE CMNS STE 111, BROWNSBURG, IN 46112-1792

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/20/2025
- **Last updated:** 11/06/2025