# LEGACY

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

## Provider details

- **NPI number:** 1730334640
- **Authorized official:** LARRY DEAN SCHMUCK (PTA/STAFF)
- **Authorized official phone:** (409) 962-4195

## Contact information

- **Practice address:** 4201 FM 105, ORANGE, TX 77630-1272
- **Practice address phone:** (409) 670-1457
- **Mailing address:** 4201 FM 105, ORANGE, TX 77630-1272
- **Mailing address phone:** (409) 670-1457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2019808 | TX | Yes |

## Other

- **Enumeration date:** 11/19/2008
- **Last updated:** 11/19/2008