Organization
JT LEGACY LLC
Active
Organization
JT LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENBITE SEYOUM (FOUNDER)
(919) 685-6274
Entity
Organization
Contact information
Practice address
5927 SUNRISE CT, CHARLOTTE, NC 28212-5762
(919) 685-6274
Mailing address
5927 SUNRISE CT, CHARLOTTE, NC 28212-5762
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/17/2026
Last updated
05/26/2026
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