Provider Demographics
NPI:1174352421
Name:LEGACY HEALTHCARE INC
Entity type:Organization
Organization Name:LEGACY HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:225-678-6631
Mailing Address - Street 1:9023 CAPROCK BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-8234
Mailing Address - Country:US
Mailing Address - Phone:225-678-6631
Mailing Address - Fax:
Practice Address - Street 1:11767 KATY FWY STE 1130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1731
Practice Address - Country:US
Practice Address - Phone:225-678-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care