Legacy Care Centers, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

112967 Issued in TX

Legal business name

LEGACY CARE CENTERS, INC.

Doing business as

Sycamore Care Center

Practice address

921 W Cannon St
Fort Worth, TX 76104-3026

Phone

(817) 332-9261

Fax

(817) 332-3035

NPI assigned

Jun 30, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cheryl L Killian

Title

President

Phone

(817) 654-3042

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sycamore Care Center Doing business as

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114924529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WOODSIDE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760163030",
            "telephone_number": "817-654-3042",
            "fax_number": "817-446-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043026",
            "telephone_number": "817-332-9261",
            "fax_number": "817-332-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY CARE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-654-3042",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "112967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4192",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sycamore Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Selina Ann Leewright, AGACNP-BC
• Melissa Lefan
• Regina Leffingwell, PT
• Destyne Etienne Leflore
• Jessica Marie Leflore, LPC
• Legacy Healthcare Services Inc
• Legacy Healthcare Services, Inc.
• Legacy Heart Care Inc
• Legacy Heart Care Inc
• Legacy Heart Care of Fort Worth LLC

• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.