Organization
LEGACY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WALKER HUFFMAN QMHP (CEO)
(276) 790-4649
Entity
Organization
Contact information
Practice address
263 S FORK LOOP, STUART, VA 24171-2659
(276) 790-4649
Mailing address
263 S FORK LOOP, STUART, VA 24171-2659
(276) 790-4649
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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