Organization Active NPI

Legacy Hospice LLC

  • Community Based Hospice Care Agency
  • Flint, MI
National Provider Identifier
1366236606
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LEGACY HOSPICE LLC
Practice address
2700 Robert T Longway Blvd Ste a
Flint, MI 48503-2190
Phone
(314) 250-1589
NPI assigned
Apr 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Marie Johnson, RN
Title
Ceo
Phone
(314) 250-1589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2700 Robert T Longway Blvd Ste a
Flint, MI 48503-2190

Mailing address

7619 Lions Gate Pkwy
Davison, MI 48423-3709

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1366236606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 LIONS GATE PKWY",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484233709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "314-250-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-250-1589",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.