Organization
LEGACY HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH MAILLARD MBA (OWNER)
(928) 632-2373
Entity
Organization
Contact information
Practice address
145 E MALEY ST, WILLCOX, AZ 85643-2127
(928) 632-2373
(888) 504-1425
Mailing address
145 E MALEY ST, WILLCOX, AZ 85643-2127
(928) 632-2373
(888) 504-1425
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652190
—
AZ
01
—
HHA4792
ARIZONA DEPARTMENT OF HEALTH AND HUMAN SERVICES
AZ
Enumeration date
11/04/2014
Last updated
11/04/2014
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