| Legacy Comprehensive Health Management Llc. | |
|
412 Ingleside Ave Emporia VA 23847-2320 | |
| (434) 532-2164 | |
| Not Available |
| Full Name | Legacy Comprehensive Health Management Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 412 Ingleside Ave, Emporia, Virginia |
| Authorized Official Name and Position | Crystal Jolette Mason-dickens (OWNER) |
| Authorized Official Contact | 2525788334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Comprehensive Health Management Llc. 302 S Russell St Gaston NC 27832-9784 Ph: (252) 578-8334 | Legacy Comprehensive Health Management Llc. 412 Ingleside Ave Emporia VA 23847-2320 Ph: (434) 532-2164 |
| NPI Number | 1083591911 |
|---|---|
| Provider Enumeration Date | 08/20/2025 |
| Last Update Date | 08/20/2025 |
| Certification Date | 08/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083591911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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