Legacy Healthcare Services Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LEGACY HEALTHCARE SERVICES INC

Practice address

2100 10TH Ave
Vero Beach, FL 32960-5377

Phone

(855) 239-3467

NPI assigned

May 11, 2022

Organization subpart

No

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

Authorized official

Name

Mr. William Gil Wilson Jr.

Title

Cfo

Phone

(910) 424-5080

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 696529

Legal name

LEGACY HEALTHCARE SERVICES INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Dec 21, 2023

Last certification

Dec 21, 2023

Ownership / control type

Voluntary Non-Profit Other Than Church

Facility address

2100 10TH Ave
Vero Beach, FL 32960

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1144966227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HORIZON DR STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154926",
            "telephone_number": "910-724-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 10TH AVE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605377",
            "telephone_number": "855-239-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-11",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GIL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-424-5080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Behavioral Health Center Inc
• Legacy Behavioral Health Center Inc
• Legacy Behavioral Health Center, Inc
• Legacy Behavioral Health Center, Inc
• Legacy Behavioral Health Center, Inc.
• Beatrice Leger
• Lee Richard Legler, D.M.D, M.S.
• Whitney Legler, PSY.D.
• Tina Lehman, RDH
• Maria Magdelena Leinonen, M.D.

• Physical Therapist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.