Organization Active NPI

Legacy Community Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Coral Springs, FL
National Provider Identifier
1942895792
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LEGACY COMMUNITY CENTER LLC
Practice address
10211 W Sample Rd Ste 212214
Coral Springs, FL 33065-3972
Phone
(954) 603-7177
Fax
(786) 364-7543
NPI assigned
Mar 3, 2021
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

Name
Lissette Garzon, BS, CBHCMS, CTPNPI 1851914287
Title
Ceo
Phone
(954) 600-1728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

10211 W Sample Rd Ste 212214
Coral Springs, FL 33065-3972

Mailing address

10211 W Sample Rd Ste 212214
Coral Springs, FL 33065-3972
Phone (954) 603-7177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211007002567 FL Part B Supplier - Clinic/Group Practice 1355749201 Receives reassigned benefits from 2 practitioners
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory

Locations

10211 W Sample Rd
Ste 212214
Coral Springs, FL 33065
Phone (954) 600-1728

7855 NW 12th St
Ste 217
Doral, FL 33126
Phone (954) 600-1728

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1942895792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 W SAMPLE RD STE 212214",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653972",
            "telephone_number": "954-603-7177",
            "fax_number": "786-364-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 W SAMPLE RD STE 212214",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653972",
            "telephone_number": "954-603-7177",
            "fax_number": "786-364-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "GARZON",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-600-1728",
        "authorized_official_credential": "BS, CBHCMS, CTP"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.