Organization · NPI-2

1st Legacy LLC

Assisted Living Facility, Assisted Living, Mental Illness · Dallas, TX

NPI number1730089582
StatusActive
Last updated in NPPESNov 6, 2026

Details

NPI
1730089582
Entity type
Organization (NPI-2)
Legal business name
1st Legacy LLC
Organization subpart
No
Enumeration date
Nov 6, 2026
Certification date
Nov 6, 2026
Last updated
Nov 6, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness––Yes

Practice location

2426 Jordan St
Dallas, TX 75215-3737

Phone 202-361-1275

Mailing address

111 Summit Ridge Dr
Rockwall, TX 75087-4231

Phone 202-468-6274

Other practice locations

517 Macarthur Blvd
Grand Prairie, TX 75050-4746

Phone 202-361-1275

111 Summit Ridge Dr
Rockwall, TX 75087-4231

Phone 202-468-6274

Authorized official

Negassi Bire
Director
2024686274

Is something wrong?

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