Organization
LEGENDARY SERVICE COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASEIM EZELL (OWNER)
(215) 696-2300
Entity
Organization
Contact information
Practice address
426 EAST ALLEGHENY AVE., PHILADELPHIA, PA 19134-2334
(215) 696-2300
Mailing address
426 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2338
(215) 696-2300
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
PA
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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