| Legacy Associates, Inc | |
|
8 S Franklin St Bloomfield IN 47424-1405 | |
| (812) 384-7318 | |
| Not Available |
| Full Name | Legacy Associates, Inc |
|---|---|
| Speciality | Counselor |
| Location | 8 S Franklin St, Bloomfield, Indiana |
| Authorized Official Name and Position | Debra R Hoesman (TIN OWNER) |
| Authorized Official Contact | 8123847318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Associates, Inc 4183 W Grand Ave Bloomington IN 47404-4816 Ph: (812) 384-7318 | Legacy Associates, Inc 8 S Franklin St Bloomfield IN 47424-1405 Ph: (812) 384-7318 |
| NPI Number | 1538562772 |
|---|---|
| Provider Enumeration Date | 10/02/2014 |
| Last Update Date | 10/02/2014 |
| Medicare PECOS PAC ID | 3072735141 |
|---|---|
| Medicare Enrollment ID | O20141105002595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538562772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Debra R Hoesman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023178290 PECOS PAC ID: 2668656893 Enrollment ID: I20110412000609 |
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