# LEGACY HEALTHCARE SERVICES INC.

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

## Provider details

- **NPI number:** 1710504741
- **Authorized official:** WILLIAM G WILSON JR. (CFO)
- **Authorized official phone:** (919) 424-4312

## Contact information

- **Practice address:** 487 HIGHWAY 378, LEXINGTON, SC 29072-9177
- **Practice address phone:** (888) 239-3467
- **Mailing address:** 110 HORIZON DR STE 310, RALEIGH, NC 27615-4926
- **Mailing address phone:** (910) 724-7770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 06/25/2020
- **Last updated:** 09/08/2021