Organization
LEGACY CARE LLC.
Active
Other names
Legacy Residential Care Home, Legacy Affordable Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY ANN LOCKETT ADM (ADMINISTRATOR)
(918) 378-9258
Entity
Organization
Contact information
Practice address
9125 S SHERIDAN RD STE 105, TULSA, OK 74133-5330
(918) 378-9258
Mailing address
6742 E 91ST PL APT 3, TULSA, OK 74133-5395
(918) 378-9258
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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