# LEGACY HOME CARE, INC.

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

## Provider details

- **NPI number:** 1780774067
- **Authorized official:** MR. MUKHTAR AHMAD RPT (CEO)
- **Authorized official phone:** (248) 559-9001

## Contact information

- **Practice address:** 17070 W 12 MILE RD, STE D, SOUTHFIELD, MI 48076-2116
- **Practice address phone:** (248) 559-9001
- **Practice address fax:** (248) 559-9005
- **Mailing address:** 17070 W 12 MILE RD, STE D, SOUTHFIELD, MI 48076-2116
- **Mailing address phone:** (248) 559-9001
- **Mailing address fax:** (248) 559-9005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/15/2006
- **Last updated:** 08/22/2020