Organization
LIVING LEGEND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NA'QUOYIA NELSON (DIRECTOR/MANGER)
(951) 790-8533
Entity
Organization
Contact information
Practice address
3841 N 24TH ST, PHOENIX, AZ 85016-6512
(602) 607-5427
Mailing address
16575 BONANZA DR, RIVERSIDE, CA 92504-5720
(951) 790-8533
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
07/05/2023
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