# LEGACY HEALTHCARE SERVICES, INC

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

## Provider details

- **NPI number:** 1881079929
- **Authorized official:** DERRICK WOODLEY CLARK PTA (PTA)
- **Authorized official phone:** (828) 448-1137

## Contact information

- **Practice address:** 4263 BILL DALE RD, MORGANTON, NC 28655
- **Practice address phone:** (828) 448-1137
- **Mailing address:** 4263 BILL DALE RD, MORGANTON, NC 28655-8854
- **Mailing address phone:** (828) 448-1137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 5172 | NC | — |
| 314000000X | Skilled Nursing Facility | 5172 | NC | Yes |

## Other

- **Enumeration date:** 07/29/2015
- **Last updated:** 07/29/2015