Legacy Support LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

LEGACY SUPPORT LLC

Practice address

2913 Rice Creek Pkwy NE
Blaine, MN 55449-6766

Phone

(763) 219-0826

NPI assigned

Aug 29, 2025

Organization subpart

No

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

Authorized official

Name

Abdeta Tula

Title

Owner

Phone

(612) 229-1635

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1467331850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 RICE CREEK PKWY NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496766",
            "telephone_number": "763-219-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 RICE CREEK PKWY NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496766",
            "telephone_number": "763-219-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "TULA",
        "authorized_official_first_name": "ABDETA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-229-1635"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "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 Aug 29, 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.