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Organization
R LEGACY INV LLC
Active
Organization
R LEGACY INV LLC
Active
Other names
Beulahland Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
TROY K RICKLES (OWNER)
(304) 669-4829
Entity
Organization
Contact information
Practice address
4706 KNOTTSVILLE RD, GRAFTON, WV 26354-7286
(304) 265-2874
Mailing address
4107 S TAMIAMI TRL # 326, VENICE, FL 34293-5109
(304) 669-4829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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