Organization
LEGACY HOME HEALTH AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICE LAVERNE RATNASWAMY PROVIDER (DIRECTOR/CEO)
(407) 600-8554
Entity
Organization
Contact information
Practice address
750 S ORANGE BLOSSOM TRL STE 116, ORLANDO, FL 32805-3154
(407) 906-3022
Mailing address
750 S ORANGE BLOSSOM TRL STE 116, ORLANDO, FL 32805-3154
(407) 906-3022
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
672186
—
FL
Enumeration date
07/05/2017
Last updated
07/21/2022
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