# LEGACY HEALTHCARE

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

## Provider details

- **NPI number:** 1629407036
- **Authorized official:** ANGELA GRANT (GENERAL COUNSEL & VP OF HUMAN RES.)
- **Authorized official phone:** 19194245086

## Contact information

- **Practice address:** 106 MOUNT VISTA RD, DENTON, NC 27239-8793
- **Practice address phone:** (336) 859-0773
- **Mailing address:** 3001 SPRING FOREST RD, RALEIGH, NC 27616-2815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1089 | NC | Yes |

## Other

- **Enumeration date:** 11/06/2013
- **Last updated:** 11/06/2013