# R LEGACY INV LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beulahland Assisted Living
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861253569
- **Authorized official:** TROY K RICKLES (OWNER)
- **Authorized official phone:** (304) 669-4829

## Contact information

- **Practice address:** 4706 KNOTTSVILLE RD, GRAFTON, WV 26354-7286
- **Practice address phone:** (304) 265-2874
- **Mailing address:** 4107 S TAMIAMI TRL \# 326, VENICE, FL 34293-5109
- **Mailing address phone:** (304) 669-4829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2024
- **Last updated:** 01/19/2024