Regis Legacy LLC

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

REGIS LEGACY LLC

Practice address

21310 Plum Gate CT
Richmond, TX 77407-1425

Phone

(832) 613-4377

NPI assigned

Aug 15, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Oluwasegun Isaac Oludiran

Title

President

Phone

(832) 613-4377

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1245062439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21310 PLUM GATE CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071425",
            "telephone_number": "832-613-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21310 PLUM GATE CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071425",
            "telephone_number": "832-613-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIS LEGACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "OLUDIRAN",
        "authorized_official_first_name": "OLUWASEGUN",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-613-4377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.