Organization
LEGACY BHC
Active
Parent organization
LEGACY BHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY BHC
Authorized official
PLACIDA SUAREZ TCM (TARGET CASE MANAGER)
(772) 631-6892
Entity
Organization
Contact information
Practice address
4747 SE DUVAL DRIVE, STUART, FL 34997
(772) 631-6892
(772) 597-6399
Mailing address
4747 SE DUVAL DR, STUART, FL 34997-1504
(772) 631-6892
(772) 597-6399
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
FL
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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