Organization
MARIANNE'S LEGACY HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARTLYNE ALEXIS RN (CEO)
(516) 902-7088
Entity
Organization
Contact information
Practice address
23515 VALDERAMA LN, SORRENTO, FL 32776-6937
(516) 902-7088
Mailing address
4406 W COPLEN FARMS RD, LAVEEN, AZ 85339-7131
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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