| Legacy Life Care Programs-brentwood | |
|
1661 Mallory Ln Brentwood TN 37027-7931 | |
| (931) 626-1644 | |
| (931) 381-5363 |
| Full Name | Legacy Life Care Programs-brentwood |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1661 Mallory Ln, Brentwood, Tennessee |
| Authorized Official Name and Position | Linda R Smith (CEO/PRESIDENT) |
| Authorized Official Contact | 9312152182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Life Care Programs-brentwood 100 N. Bigby Dr. Columbia TN 38401-4704 Ph: (931) 215-2182 | Legacy Life Care Programs-brentwood 1661 Mallory Ln Brentwood TN 37027-7931 Ph: (931) 626-1644 |
| NPI Number | 1962746842 |
|---|---|
| Provider Enumeration Date | 11/16/2012 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962746842 | NPI | - | NPPES |
| H445654 | Medicaid | TN | |
| Q010864 | Medicaid | TN | |
| 1962746842 | Other | TN | GROUP NPI |
| 1437420742 | Medicaid | TN | |
| NPI 1265768428 | Other | TN | SUPERVISOR |
| 1225450802 | Other | TN | INDIVIDUAL PROVIDER NPI |
| 1669548608 | Other | TN | SUPERVISING PROVIDER NPI |
| Q006613 | Medicaid | TN |
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