Organization
LEGACY PROVIDER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY LABRADO (PRESIDENT/CEO)
(872) 444-4896
Entity
Organization
Contact information
Practice address
1600 JOLLA DEL SOL, EL PASO, TX 79911-3005
(872) 444-4896
Mailing address
1600 JOLLA DEL SOL, EL PASO, TX 79911-3005
(915) 474-5916
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193200000X
—
TX
05
—
251B00000X
—
TX
05
—
251C00000X
—
TX
05
—
251E00000X
—
TX
05
—
253Z00000X
—
TX
05
—
305R00000X
—
TX
05
—
320600000X
—
TX
05
—
3209800000X
—
TX
05
—
3747A0650X
—
TX
05
—
3747P1801X
—
TX
05
—
385H00000X
—
TX
Enumeration date
06/19/2025
Last updated
09/05/2025
Update your record
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