Organization · NPI-2
I Am Legacy Ptca INC.
Voluntary or Charitable · Albany, GA
NPI number1003630427
StatusActive
Last updated in NPPESNov 12, 2024
Details
- NPI
- 1003630427
- Entity type
- Organization (NPI-2)
- Legal business name
- I Am Legacy Ptca INC.
- Organization subpart
- No
- Enumeration date
- Nov 12, 2024
- Certification date
- Nov 12, 2024
- Last updated
- Nov 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251V00000X | Voluntary or Charitable | – | – | Yes |
| 251B00000X | Case Management | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 251K00000X | Public Health or Welfare | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 252Y00000X | Early Intervention Provider Agency | – | – |
Practice location
514 W Oglethorpe BlvdAlbany, GA 31701-1478
Phone 404-465-1391
Mailing address
514 W Oglethorpe Blvd Ste GAlbany, GA 31701-1479
Phone 404-465-1391
Authorized official
Evangela Childs
Executive Director
4044651391
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