Organization
LEGACY THERAPY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMBROSE HERNANDEZ (CEO/OWNER)
(361) 855-0848
Entity
Organization
Contact information
Practice address
5633 S. STAPLES STREET, SUITE 400 & 500, CORPUS CHRISTI, TX 78466-1140
(361) 855-1352
(361) 855-1254
Mailing address
P.O. BOX 61140, CORPUS CHRISTI, TX 78466-1140
(361) 855-1352
(361) 855-1254
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
TX
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
07/30/2009
Last updated
01/14/2011
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