# LEGACY HOME CARE AGENCY

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

## Provider details

- **NPI number:** 1952508939
- **Authorized official:** MS. TRACY HASKINS (DIRECTOR)
- **Authorized official phone:** (919) 693-1067

## Contact information

- **Practice address:** 615B LEWIS ST, SUITE 106, OXFORD, NC 27565-3523
- **Practice address phone:** (919) 693-1067
- **Practice address fax:** (919) 693-1067
- **Mailing address:** PO BOX 1814, OXFORD, NC 27565-1814
- **Mailing address phone:** (919) 693-1067
- **Mailing address fax:** (919) 693-1067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | HC3574 | NC | Yes |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3418335 | — | NC |
| 05 | — | 7100597 | — | NC |