Provider Demographics
NPI:1538656459
Name:LEGACY HOLDINGS AND VENTURES LLC
Entity type:Organization
Organization Name:LEGACY HOLDINGS AND VENTURES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-355-8584
Mailing Address - Street 1:6400 MANATEE AVE W STE L106
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2364
Mailing Address - Country:US
Mailing Address - Phone:813-355-8584
Mailing Address - Fax:
Practice Address - Street 1:6400 MANATEE AVE W STE L106
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2364
Practice Address - Country:US
Practice Address - Phone:813-355-8584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health