NPIMap

Organization Active NPI

Legacy Human Services, Inc.

  • Community/Behavioral Health Agency
  • Henderson, NC
National Provider Identifier
1962531491
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL 091 006 Issued in NC
Legal business name
LEGACY HUMAN SERVICES, INC.
Practice address
630 S Garnett St
Henderson, NC 27536-4509
Phone
(252) 492-0328
Fax
(252) 492-5255
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Lynn Fleming
Title
Finance Director
Phone
(252) 492-8699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL 091 006 NC Primary

Addresses

Primary practice location

630 S Garnett St
Henderson, NC 27536-4509

Mailing address

PO Box 88
Henderson, NC 27536-0088
Phone (252) 492-8699

Other identifiers 2

IdentifierTypeStateIssuer
8300479SMedicaidNC
8300479MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Legacy Human Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1962531491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275360088",
            "telephone_number": "252-492-8699",
            "fax_number": "252-492-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S GARNETT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364509",
            "telephone_number": "252-492-0328",
            "fax_number": "252-492-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HUMAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "252-492-8699"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL 091 006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300479S",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300479",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.