Organization
LEGACY HOUSE COMMUNITY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCINE ROBERTSON (OWNER)
(901) 215-6101
Entity
Organization
Contact information
Practice address
11747 N 19TH AVE STE 104, PHOENIX, AZ 85029-3590
(901) 215-6101
Mailing address
11747 N 19TH AVE STE 104, PHOENIX, AZ 85029-3590
(901) 215-6101
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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