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Organization
LEGACY BRIDGE SUPPORT SERVICES LLC
Active
Organization
LEGACY BRIDGE SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANESHA FRAZIER (OWNER/CEO/EXECUTIVE DIRECTOR)
(615) 987-2523
Entity
Organization
Contact information
Practice address
2615 MEDICAL CENTER PKWY, MURFREESBORO, TN 37129-2261
(615) 318-0822
Mailing address
311 S BILBRO AVE, MURFREESBORO, TN 37130-4417
(615) 987-2523
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/07/2026
Last updated
08/25/2026
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