Organization
LEGACY HEALTHCARE
Active
Organization
LEGACY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE MARIE FRANKLIN COTA/L (COTA/L REHAB DIRECTOR)
(601) 870-0618
Entity
Organization
Contact information
Practice address
363 JUNGERMANN RD, 261, SAINT PETERS, MO 63376-5371
(636) 244-3921
(636) 244-3922
Mailing address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2014012743
MO
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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