Active NPI
Legacy Life Enrichment LLC
- Intellectual Disabilities Intermediate Care Facility
- Gaston, SC
National Provider Identifier
1841103892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- LEGACY LIFE ENRICHMENT LLC
- Practice address
- 166 Woodcrest LN
Gaston, SC 29053-9523 - Phone
- (803) 413-3622
- NPI assigned
- Sep 22, 2026
- Last updated
- Sep 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda Wickens
- Title
- Owner
- Phone
- (803) 413-3622
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
166 Woodcrest LN
Gaston, SC 29053-9523
Mailing address
166 Woodcrest LN
Gaston, SC 29053-9523
Phone (803) 413-3622
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Clinical Social Worker
- Sumter, SC
- NPI 1841937471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790035200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790035200000",
"number": "1841103892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 WOODCREST LN",
"city": "GASTON",
"state": "SC",
"postal_code": "290539523",
"telephone_number": "803-413-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 WOODCREST LN",
"city": "GASTON",
"state": "SC",
"postal_code": "290539523",
"telephone_number": "803-413-3622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY LIFE ENRICHMENT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-22",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A",
"authorized_official_last_name": "WICKENS",
"authorized_official_first_name": "LINDA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "803-413-3622"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.