Organization
LEGACY NATIVE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRESE M TOMEGAH (CEO)
(480) 865-5244
Entity
Organization
Contact information
Practice address
5235 S AXIOM, MESA, AZ 85212-8529
(480) 245-4471
Mailing address
5235 S AXIOM, MESA, AZ 85212-8529
(480) 245-4471
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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