Organization
LEGACY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI ANNE PITMAN OT (OCCUPATIONAL THERAPIST)
(704) 435-0108
Entity
Organization
Contact information
Practice address
3100 SPRING FOREST RD, RALEIGH, NC 27616-2880
(704) 435-0108
Mailing address
3100 SPRING FOREST RD, RALEIGH, NC 27616-2880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000000000009
NC
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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