Legacy Therapeutic Solutions LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

LEGACY THERAPEUTIC SOLUTIONS LLC

Practice address

96020 Bass LN
Yulee, FL 32097-6592

Phone

(904) 490-0489

Fax

(904) 490-8389

NPI assigned

Jan 7, 2020

Organization subpart

No

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

Authorized official

Name

Kenyetta Morales

Title

Owner

Phone

(704) 604-4699

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1952941999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96020 BASS LN",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976592",
            "telephone_number": "704-604-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96020 BASS LN",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320976592",
            "telephone_number": "904-490-0489",
            "fax_number": "904-490-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY THERAPEUTIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "KENYETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-604-4699"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Yulee, FL
• Providers in Yulee, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.