Organization
LEGACY CARE LLC
Active
Organization
LEGACY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON AMEDAI (OWNER)
(480) 349-0813
Entity
Organization
Contact information
Practice address
2914 W SOLANO DR S, PHOENIX, AZ 85017-2543
(480) 349-0813
Mailing address
4327 W MALDONADO RD, LAVEEN, AZ 85339-6227
(480) 349-0813
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
Other
Enumeration date
05/07/2024
Last updated
05/13/2024
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