Legacy Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550001148 Issued in CA

Legal business name

LEGACY HOME HEALTH, INC.

Practice address

1111 W Robinhood Dr
Suite D
Stockton, CA 95207-5626

Phone

(209) 474-0111

Fax

(888) 448-8212

NPI assigned

Nov 9, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Gwendolyn Boss

Title

President

Phone

(209) 483-3466

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1033446299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W ROBINHOOD DR",
            "address_2": "SUITE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075626",
            "telephone_number": "209-474-0111",
            "fax_number": "888-448-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W ROBINHOOD DR",
            "address_2": "SUITE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075626",
            "telephone_number": "209-474-0111",
            "fax_number": "888-448-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "BOSS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-483-3466",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550001148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.