Organization
LEGACY SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDETA TULA (OWNER)
(612) 229-1635
Entity
Organization
Contact information
Practice address
2913 RICE CREEK PKWY NE, BLAINE, MN 55449-6766
(763) 219-0826
Mailing address
2913 RICE CREEK PKWY NE, BLAINE, MN 55449-6766
(763) 219-0826
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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