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Organization
LEGACY HOME CARE LC
Active
Organization
LEGACY HOME CARE LC
Active
Other names
Legacy Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER WAYDE SONDRUP PT (OWNER ADMINISTRATOR)
(208) 888-3669
Entity
Organization
Contact information
Practice address
680 S PROGRESS AVE, SUITE 2A, MERIDIAN, ID 83642-2957
(208) 888-3669
(208) 888-3675
Mailing address
680 S PROGRESS AVE, SUITE 2A, MERIDIAN, ID 83642-2957
(208) 888-3669
(208) 888-3675
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HH-224
ID
Other
Enumeration date
01/08/2007
Last updated
08/07/2007
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