Legacy Healthcare Advantage Llc

LBN: Legacy Healthcare Advantage Llc
Legacy Healthcare Advantage Llc is an health care organization with primary practice located at 371 E Henry St , Spartanburg SC 29302-2607. The organization recently has 13 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Home Health, Agencies / Hospice Care, Community Based, Agencies / Nursing Care, Agencies / Community/Behavioral Health, Agencies / In Home Supportive Care, Laboratories / Clinical Medical Laboratory, Managed Care Organizations / Health Maintenance Organization, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Respite Care Facility / Respite Care, Mental Illness, Child, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Physical Disabilities, Child. Agencies / In Home Supportive Care is the primary health care specialty. Legacy Healthcare Advantage Llc can be contacted via phone (864) 431-4273, or through Wilkes, Cortella via phone (864) 308-8712.

Contact Information

Primary practice address
371 E Henry St Spartanburg SC 29302-2607
Phone: (864) 431-4273
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wilkes, Cortella
Phone: (864) 308-8712

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Home Health 251E00000X
Agencies / Hospice Care, Community Based 251G00000X
Agencies / Nursing Care 251J00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / In Home Supportive Care 253Z00000X
Laboratories / Clinical Medical Laboratory 291U00000X
Managed Care Organizations / Health Maintenance Organization 302R00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X
Respite Care Facility / Respite Care 385H00000X
Respite Care Facility / Respite Care, Mental Illness, Child 385HR2055X
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X
Respite Care Facility / Respite Care, Physical Disabilities, Child 385HR2065X

Profile Details

NPI number 1568974863
LBN Legal business name Legacy Healthcare Advantage Llc
DBA Doing business as
Authorized official Wilkes, Cortella
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2017
Last updated Aug 16th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568974863 NPPES
South Carolina MEDICAID EN1733

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