# LASTING LEGACY HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LASTING LEGACY HOME CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912834243
- **Authorized official:** HENRY BOLTON JR. (OWNER)
- **Authorized official phone:** (706) 564-1472

## Contact information

- **Practice address:** 463688 STATE ROAD 200 STE 1522, YULEE, FL 32097-0304
- **Practice address phone:** (904) 849-5192
- **Mailing address:** 81508 BOATSWAIN CT, FERNANDINA BEACH, FL 32034-7118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2026
- **Last updated:** 05/08/2026