LEGACY HUMAN SERVICES INC. NPI 1902075690

NPI Information

  • NPI: 1902075690
  • Provider Name: LEGACY HUMAN SERVICES, INC.
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Address: 109 MUSTIAN ROAD
    WARREN COUNTY GROUP HOME
    RIDGEWAY, NC
    ZIP 27570
  • Phone: (252) 456-3177

Map and Directions

Get Directions

NPI Details

LEGACY HUMAN SERVICES, INC. is an adult care home custodial care facility in Ridgeway, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. LEGACY HUMAN SERVICES, INC. NPI is 1902075690. The provider is registered as an organization entity type.

The provider's business location address is:

109 MUSTIAN ROAD
WARREN COUNTY GROUP HOME
RIDGEWAY, NC
ZIP 27570
Phone: (252) 456-3177

The provider's authorized official is Jacinta Johnson .
The authorized official title is Executive Director and has the following contact phone number (252) 438-6700.

The enumeration date for this NPI number is 2/27/2008 and was last updated on 9/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-093-031NORTH CAROLINANo
2251S00000XCommunity/Behavioral HealthNo
3311ZA0620XCustodial Care FacilityAdult Care HomeMHL-093-031NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17805489MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.