Organization
LEGACY OF FOUR SISTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYNA INGABIRE (DIRECTOR)
(920) 515-1534
Entity
Organization
Contact information
Practice address
N9351 S LAKE PARK RD UNIT 132, APPLETON, WI 54915-9488
(920) 515-1534
Mailing address
N9351 S LAKE PARK RD UNIT 132, APPLETON, WI 54915-9488
(920) 515-1534
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/29/2026
Last updated
08/09/2026
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