Organization
LEGACY HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATASHA N CARGO (PRESIDENT)
(646) 875-6181
Entity
Organization
Contact information
Practice address
200 W 131ST ST APT 10C, NEW YORK, NY 10027-2041
(646) 875-6181
Mailing address
200 W 131ST ST APT 10C, NEW YORK, NY 10027-2041
(646) 875-6181
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
174200000X
Meals Provider
—
—
251S00000X
Community/Behavioral Health Agency
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
310400000X
Assisted Living Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/16/2020
Last updated
04/16/2020
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