Active NPI
Legacy Community Center LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Coral Springs, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- 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, 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
- Lissette Garzon, BS, CBHCMS, CTP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.
-
- Case Manager/Care Coordinator
- Coral Springs, FL
- NPI 1851914287
-
- Clinical Social Worker
- Miami Beach, FL
- NPI 1184246456
-
- Physician Assistant
- Miami, FL
- NPI 1205505252
-
- Psychiatry Physician
- Miami, FL
- NPI 1033536131
-
- Marriage & Family Therapist
- Weston, FL
- NPI 1467169151
-
- Psychiatric/Mental Health Nurse Practitioner
- Miami, FL
- NPI 1619586591
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.