Legacy Healing Health Communty LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LEGACY HEALING HEALTH COMMUNTY LLC

Practice address

1526 W Glendale Ave Ste 109
Phoenix, AZ 85021-8576

Phone

(480) 692-0247

NPI assigned

Apr 12, 2022

Organization subpart

No

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

Authorized official

Name

Moses Ntirenganya

Title

Ceo

Phone

(480) 692-0247

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650672000000",
    "number": "1083356877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 N 22ND AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152815",
            "telephone_number": "480-692-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 W GLENDALE AVE STE 109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218576",
            "telephone_number": "480-692-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALING HEALTH COMMUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A",
        "authorized_official_last_name": "NTIRENGANYA",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-692-0247"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; 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.