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Organization

LEGACY BRIDGE SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KANESHA FRAZIER (OWNER/CEO/EXECUTIVE DIRECTOR)
(615) 987-2523
Entity
Organization

Contact information

Practice address
2615 MEDICAL CENTER PKWY, MURFREESBORO, TN 37129-2261
(615) 318-0822
Mailing address
311 S BILBRO AVE, MURFREESBORO, TN 37130-4417
(615) 987-2523

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
252Y00000X
Early Intervention Provider Agency
253J00000X
Foster Care Agency
253Z00000X
In Home Supportive Care Agency
261Q00000X
Clinic/Center
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
01/07/2026
Last updated
03/18/2026
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