Provider Demographics
NPI:1639066467
Name:OUR LEGACY HEALTHCARE, LLC
Entity type:Organization
Organization Name:OUR LEGACY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MALISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-258-9160
Mailing Address - Street 1:41 ROAD 5457
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-1441
Mailing Address - Country:US
Mailing Address - Phone:505-258-9160
Mailing Address - Fax:
Practice Address - Street 1:41 ROAD 5457
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-1441
Practice Address - Country:US
Practice Address - Phone:505-258-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health