NPI 1376962621

Legacy Healthcare

Organisation Physical Disabilities Residential Treatment Facility Raleigh, NC

Practice location

Address: 3001 Spring Forest Rd, Raleigh, NC 27616-2815
Phone: (919) 424-5080

Authorised official

Name: Kim Florene Fultz
Title: Lpta
Phone: (336) 307-6056

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 2870 (NC)

Other Residential Treatment Facility, Physical Disabilities providers in North Carolina →

Registry record

NPI: 1376962621
Entity type: Organization
NPI issued: 15 Apr 2014
Record last updated: 15 Apr 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.