# LEGENDARY THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEGENDARY THERAPY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760869390
- **Legal business name:** LEGENDARY THERAPY
- **Authorized official:** MRS. RACHEL WEIS (DIRECTOR)
- **Authorized official phone:** (917) 460-7098

## Contact information

- **Practice address:** 91-63 110ST, RICHMOND HILL, NY 11418
- **Practice address phone:** (917) 723-6653
- **Mailing address:** 9163 110TH ST, RICHMOND HILL, NY 11418-2310
- **Mailing address phone:** (917) 723-6653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 24582 | NY | Yes |

## Other

- **Enumeration date:** 05/04/2015
- **Last updated:** 05/04/2015