| Legacy Community Health Services, Inc | |
|
2965 Harrison St Ste 320 Beaumont TX 77702-1150 | |
| (409) 899-1360 | |
| (713) 523-4897 |
| Full Name | Legacy Community Health Services, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2965 Harrison St Ste 320, Beaumont, Texas |
| Authorized Official Name and Position | Katherine Caldwell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 83254855051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Community Health Services, Inc Po Box 66308 Houston TX 77266-6308 Ph: (832) 548-5076 | Legacy Community Health Services, Inc 2965 Harrison St Ste 320 Beaumont TX 77702-1150 Ph: (409) 899-1360 |
| NPI Number | 1063750669 |
|---|---|
| Provider Enumeration Date | 01/17/2013 |
| Last Update Date | 01/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063750669 | NPI | - | NPPES |
| 080462703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H80CS07502 HRSA ID (Texas) | Primary |
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