Organization
LEGACY850 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VERONDA ROBINSON (MANAGER)
(850) 868-1002
Entity
Organization
Contact information
Practice address
111 HENRY DRIVE, GRETNA, FL 32332
(850) 868-1002
Mailing address
PO BOX 1701, QUINCY, FL 32353-1701
(850) 868-1002
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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