Provider Demographics
NPI:1649473307
Name:OUR LEGACY VENTURES LLC
Entity type:Organization
Organization Name:OUR LEGACY VENTURES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LINWOOD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-644-1076
Mailing Address - Street 1:4901 FITZHUGH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3531
Mailing Address - Country:US
Mailing Address - Phone:804-644-1076
Mailing Address - Fax:804-644-4005
Practice Address - Street 1:4901 FITZHUGH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3531
Practice Address - Country:US
Practice Address - Phone:804-644-1076
Practice Address - Fax:804-644-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-339PC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health