CCN: 676102 NPI: 1033772413 Organization

LEGACY AT JACKSONVILLE

810 BELLAIRE ST
JACKSONVILLE, TX 757669045

Contact Information

Phone 9035895300
Enumeration Date 2019-04-21
Last Updated 2019-04-21

Taxonomies

Code: 314000000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 7

cbsaActualGeographicLocation 45

providerType 38

vbpAdjustment 0.9820587514

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 45

providerType 38

specialPaymentIndicator

carrierCode 04412

localityCode 99