Organization
YOUR LEGACY HOME CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONJA SIMMONS NORMAN DNP (OWNER)
(704) 817-7706
Entity
Organization
Contact information
Practice address
9700 RESEARCH DR STE 107, CHARLOTTE, NC 28262-8569
(704) 817-7706
(704) 817-8293
Mailing address
9700 RESEARCH DR STE 107, CHARLOTTE, NC 28262-8569
(704) 817-7706
(704) 817-8293
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC6385
NORTH CAROLINA DHHS
NC
Enumeration date
01/05/2022
Last updated
01/05/2022
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