Legacy Residential Program

NPI #1003506171 in Philadelphia, Pennsylvania

Provider Information

NPI Number: 1003506171
Entity Type: Organization
Organization Name: Legacy Residential Program
Primary Specialty: Case Management
Enumeration Date: May 11, 2023
Last Updated: May 11, 2023

Practice Location

Address: 2156 N 30TH ST
City: Philadelphia
State: Pennsylvania
ZIP Code: 19121-1101
Phone: (267) 315-5124

Authorized Official

Name: MRS. ASHLEY EDWARDS, RN
Title: CEO
Phone: (215) 397-7823

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness	3104A0625X
Intermediate Care Facility, Intellectual Disabilities	315P00000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X
Community Based Residential Treatment Facility, Mental Illness	320800000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X
Psychiatric Residential Treatment Facility	323P00000X
Substance Abuse Rehabilitation Facility	324500000X
Case Management	251B00000X	Primary

Similar Providers

Provider Name	Specialty	City
Nessa Williams	Case Management	Philadelphia	AI Deep Dive
MRS. Simone Morgan	Case Management	Philadelphia	AI Deep Dive
Cache Whitaker	Case Management	Philadelphia	AI Deep Dive
Megan Lawler	Case Management	Philadelphia	AI Deep Dive
Jennifer Powell-Folks	Case Management	Philadelphia	AI Deep Dive

Want to research this healthcare provider further?