Organization
LEGACY COMMUNITY HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE CALDWELL (EXECUTIVE DIRECTOR)
83254855051
Entity
Organization
Contact information
Practice address
2965 HARRISON ST STE 320, BEAUMONT, TX 77702-1150
(409) 899-1360
(713) 523-4897
Mailing address
PO BOX 66308, HOUSTON, TX 77266-6308
(832) 548-5076
(713) 523-4897
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
H80CS07502 HRSA ID
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080462703
—
TX
Enumeration date
01/17/2013
Last updated
01/17/2013
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