Nina'S Legacy Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

NINA'S LEGACY HOME CARE LLC

Practice address

5435 Forest Dr
Lake Park, GA 31636-3326

Phone

(229) 516-2503

NPI assigned

Dec 15, 2025

Organization subpart

No

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

Authorized official

Name

Agnes Hines

Title

Owner

Phone

(229) 516-2503

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1376407288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 FOREST DR",
            "city": "LAKE PARK",
            "state": "GA",
            "postal_code": "316363326",
            "telephone_number": "229-516-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 FOREST DR",
            "city": "LAKE PARK",
            "state": "GA",
            "postal_code": "316363326",
            "telephone_number": "229-516-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINA'S LEGACY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "AGNES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-516-2503"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Dec 15, 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.