Organization
I AM LEGACY PTCA INC.
Active
Organization
I AM LEGACY PTCA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANGELA CHILDS (EXECUTIVE DIRECTOR)
(404) 465-1391
Entity
Organization
Contact information
Practice address
514 W OGLETHORPE BLVD, ALBANY, GA 31701-1478
(404) 465-1391
Mailing address
514 W OGLETHORPE BLVD STE G, ALBANY, GA 31701-1479
(404) 465-1391
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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