Organization
LEGACY CARE LLC
Active
Other names
Legacy Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEWUQETU ABEBE MEKURIYA (DIRECTOR)
(202) 352-4712
Entity
Organization
Contact information
Practice address
6108 SE CLATSOP ST, PORTLAND, OR 97206-0708
(202) 352-4712
Mailing address
6108 SE CLATSOP ST, PORTLAND, OR 97206-0708
(202) 352-4712
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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