Organization
LEGACY PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOCYLANN MURRILL COOKE (EXECUTIVE DIRECTOR)
(919) 895-9212
Entity
Organization
Contact information
Practice address
151 S HORNER BLVD, SANFORD, NC 27330-4216
(919) 895-9212
Mailing address
PO BOX 501, SANFORD, NC 27331-0501
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251T00000X
PACE Provider Organization
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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