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Organization
LEGACY CARE NURSING
Active
Organization
LEGACY CARE NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNELL JOHNSON RN214043 (COO)
(678) 488-5380
Entity
Organization
Contact information
Practice address
14 MEADOW VALLEY CT, MIDLAND, GA 31820-4393
(706) 464-1589
Mailing address
3240 DEVILLA TRCE, COLLEGE PARK, GA 30349-4057
(678) 488-5380
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
NULL
163WH0200X
Home Health Registered Nurse
Primary
—
—
251E00000X
Home Health Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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