Organization
LEGACY HOME HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY L PETERSON (ADMINISTRATOR)
(928) 443-9331
Entity
Organization
Contact information
Practice address
3607 CROSSINGS DR, SUITE A, PRESCOTT, AZ 86305-7149
(928) 443-9331
(928) 443-9332
Mailing address
3607 CROSSINGS DR, SUITE A, PRESCOTT, AZ 86305-7149
(928) 443-9331
(928) 443-9332
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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