Legacy Provider Services
LBN: Legacy Provider Services
Legacy Provider Services is an health care organization with primary practice located at 1600 Jolla Del Sol , El Paso TX 79911-3005. The organization recently has 8 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Day Training, Developmentally Disabled Services, Agencies / Home Health, Agencies / Community/Behavioral Health, Agencies / In Home Supportive Care, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care. Agencies / Case Management is the primary health care specialty.
Legacy Provider Services can be contacted via phone (872) 444-4896, or through Labrado, Rosemary via phone (872) 444-4896.
Contact Information
Primary practice address
1600 Jolla Del Sol
El Paso TX 79911-3005
Phone: (872) 444-4896
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Case Management | 251B00000X | ||
| Agencies / Day Training, Developmentally Disabled Services | 251C00000X | ||
| Agencies / Home Health | 251E00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X | ||
| Agencies / In Home Supportive Care | 253Z00000X | ||
| Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320600000X | ||
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X | ||
| Respite Care Facility / Respite Care | 385H00000X |
Profile Details
| NPI number | 1003703463 |
|---|---|
| LBN Legal business name | Legacy Provider Services |
| DBA Doing business as | |
| Authorized official | Labrado, Rosemary |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 19th, 2025 |
| Last updated | Sep 5th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003703463 | NPPES |
| Texas | MEDICAID | 193200000X | |
| Texas | MEDICAID | 305R00000X | |
| Texas | MEDICAID | 320600000X | |
| Texas | MEDICAID | 251E00000X | |
| Texas | MEDICAID | 251B00000X | |
| Texas | MEDICAID | 253Z00000X | |
| Texas | MEDICAID | 3209800000X | |
| Texas | MEDICAID | 3747A0650X | |
| Texas | MEDICAID | 251C00000X | |
| Texas | MEDICAID | 3747P1801X | |
| Texas | MEDICAID | 385H00000X |
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