Legacy Wellness Services Llc

LBN: Legacy Wellness Services Llc
Legacy Wellness Services Llc is an health care organization with primary practice located at 6068 Us Hwy 98 West , Hattiesburg MS 39402. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Ambulatory Health Care Facilities / Adult Mental Health. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Legacy Wellness Services Llc can be contacted via phone (228) 231-0516, or through Lewis, Nicole via phone (228) 231-0516.

Contact Information

Primary practice address
6068 Us Hwy 98 West Hattiesburg MS 39402
Phone: (228) 231-0516
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lewis, Nicole LCSW, LICSW
Phone: (228) 231-0516

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X

Profile Details

NPI number 1912579202
LBN Legal business name Legacy Wellness Services Llc
DBA Doing business as
Authorized official Lewis, Nicole LCSW, LICSW
Entity Organization
Organization subpart 1 No
Enumeration date Jul 15th, 2021
Last updated Jul 15th, 2021 - about 5 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 1912579202 NPPES
Other NONE BLUE CROSS BLUE SHIELD

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