LEGACY HEALTHCARE, INC. (NPI# 1760915243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760915243 |
| Entity Type | Organization |
| Organization Name | LEGACY HEALTHCARE, INC. |
| Practice Address |
3610 Bosque Plz Nw Albuquerque NM 87120-4295 |
| Practice Telephone | 5053383702 |
| Practice Fax Number | 5053383709 |
| Mailing Telephone | 5053383702 |
| Mailing Fax Number | 5053383709 |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2020-02-04 |
| Authorized Official Name | JIMMY MELTON (PRESIDENT AND CEO) |
| Authorized Official Telephone | 5059177998 |
| Is Organization Subpart | Y |
| Parent Organization Name | LEGACY HEALTHCARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 3338 | NM | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063792950 | Legacy Healthcare, Inc. | Skilled Nursing Facility | 6401 Auburn Dr, Virginia Beach, VA 23464-3601 | 2011-08-23 |
| 1952417214 | Legacy Healthcare, Inc. | Home Health | 3135 N Fairfield Rd, Suite A, Layton, UT 84041-8832 | 2006-08-21 |
| Street Address |
3610 BOSQUE PLZ NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87120-4295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013230069 | Legacy Healthcare, Inc | Home Health | 3610 Bosque Plz Nw, Albuquerque, NM 87120-4295 | 2010-03-04 |
| 1881024826 | Legacy Healthcare Inc. | Hospice Care, Community Based | 3610 Bosque Plz Nw, Albuquerque, NM 87120-4295 | 2013-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971919 | Erica Denise Ortiz | Social Worker | 6212 Casa Blanca Dr Nw, Albuquerque, NM 87120 | 2020-10-27 |
| 1770133589 | Laura Lee Smith | Technician | 5112 Vista De Luz Nw, Albuquerque, NM 87120 | 2019-09-13 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1831753508 | Jennifer Lydia Castro | Nurse Practitioner | 8428 Hawk Eye Rd Nw, Albuquerque, NM 87120 | 2019-04-27 |
| 1518425065 | Jean Louise Ramsey | Counselor | Office Alternatives/ The Center for Life Changes, 6300 Riverside Plaza Nw, Suite 100, Albuquerque, NM 87120 | 2019-03-04 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1417443276 | Kyle Thomas Lantz | Dentist | 2800-a Coors Blvd Nw, Albuquerque, NM 87120 | 2018-07-05 |
| 1437669736 | Beatrice Ottomanelli | Day Training/Habilitation Specialist | 9180 Coors Blvd. Nw, Apt. 3307, Albuquerque, NM 87120 | 2017-10-02 |
| 1740705516 | Alianza Home Care, LLC | Home Health | 8307 Casa Negra Ct Nw, Albuquerque, NM 87120 | 2017-08-13 |
| 1366963399 | Jamie Farris | Registered Nurse | 8201 Golf Course Road Northwest, Suite D3 #121, Albuquerque, NM 87120 | 2017-06-29 |
| Find all providers in zip 87120 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386977 | Gina D Padilla | Home Health | 1307 San Pedro Dr Ne, Albuquerque, NM 87110-6727 | 2020-11-04 |
| 1598365066 | Ricelands Home Health Care and Hospice LLC | Home Health | 9215 Layton Ave Ne, Albuquerque, NM 87111-1335 | 2020-10-26 |
| 1073135216 | At Home Not Alone Care, LLC | Home Health | 3410 Anderson Ave Se Rear, Albuquerque, NM 87106-2408 | 2020-05-11 |
| 1396370383 | Md Health Care LLC | Home Health | 8019 Edith Blvd Ne Ste 206, Albuquerque, NM 87113-1433 | 2020-03-10 |
| 1124650817 | United One Home Care LLC | Home Health | 3321b Candelaria Rd Ne Ofc 320, Albuquerque, NM 87107-1908 | 2020-02-10 |
| 1316595184 | Simplicity Home Health Care | Home Health | 7920 Mountain Rd Ne Ste B, Albuquerque, NM 87110-7800 | 2019-08-26 |
| 1952960817 | Mary T Martinez | Home Health | 585 Osuna Rd Ne Ste F, Albuquerque, NM 87113-1084 | 2019-06-12 |
| 1689230658 | Norma Araceli Ortega | Home Health | 9319 Starboard Rd Nw, Albuquerque, NM 87121-1968 | 2019-05-15 |
| 1134618432 | Alexis Duran | Home Health | 11005 Desert Dreamer St Nw, Albuquerque, NM 87114-6509 | 2018-05-02 |
| 1821599226 | La Vita Bella Home Health LLC | Home Health | 5901 Indian School Rd Ne Ste 102, Albuquerque, NM 87110-5200 | 2018-02-22 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87120 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.