Organization
THE LEGACY HOUSE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE FOLSOM MS (LMHC)
(850) 331-0134
Entity
Organization
Contact information
Practice address
2615 W 23RD ST, PANAMA CITY, FL 32405-2339
(850) 331-0134
(850) 306-6721
Mailing address
2615 W 23RD ST, PANAMA CITY, FL 32405-2339
(850) 331-0134
(850) 306-6721
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
08/07/2020
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