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LEGACY HEALTHCARE PROVIDERS, INC.
NPI 1003970104
Home Health in Covina, CA

Active since December 21, 2006CLIA 05D1009096 · Waiver
1272 CENTER COURT DR, STE. 203, COVINA, CA 91724(626) 858-5611(626) 858-5614 Get Directions Write a Review

NPPES record last updated: December 17, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Healthcare Providers, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY HEALTHCARE PROVIDERS, INC. (NPI 1003970104) is a healthcare organization registered as a home health in Covina, California and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through February 5, 2027 and lists Mariegene Cacho, Administrator, Owner, as its authorized official.

NPPES Registry Identity

NPI1003970104
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameLEGACY HEALTHCARE PROVIDERS, INC.
Location Address1272 CENTER COURT DR, STE. 203Covina, CA 91724-3667
Mailing Address1272 Center Court Dr, Ste. 203Covina, CA 91724-3667 · (626) 858-5611 · Fax (626) 858-5614
Phone(626) 858-5611
Fax(626) 858-5614
Organization SubpartNo
Authorized OfficialMariegene CachoAdministrator, Owner · (626) 858-5611
Enumeration DateDecember 21, 2006
Last NPPES UpdateDecember 17, 2010
✔ NPI 1003970104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in CA · 980001464
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
1272 CENTER COURT DR, Covina, CA 91724
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Other Identifiers 1

Medicare ID-Type Unspecified058207CA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1009096

Legacy Health Care Providers Inc · Covina, CA
Active · expires Feb 5, 2027
CLIA Number05D1009096
Laboratory TypeHome Health Agency
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorMukesh Amin MD
Laboratory Phone(626) 858-5611
Laboratory LocationLegacy Health Care Providers Inc1272 East Center Court Drive Suite 203, Covina, CA 91724
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE CHRISTINE CORTEZ
Social Worker (Clinical)
1272 CENTER COURT DR
COVINA, CA 91724
Los Angeles County (626) 699-0484
COMPASS CHRISTIAN PSYCHOLOGISTS, A PROFESSIONAL CORPORATION
Psychologist (Clinical)
1272 CENTER COURT DR, 103
COVINA, CA 91724
Los Angeles County (951) 310-1159
PHOEBE CERVANTES PH.D
Psychologist (Counseling)
1272 CENTER COURT DR, STE 104
COVINA, CA 91724
Los Angeles County (626) 966-5644

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Healthcare Providers, Inc.'s NPI number?

The NPI number for Legacy Healthcare Providers, Inc. is 1003970104. It was assigned to this organization in the NPPES registry on December 21, 2006.

Where is Legacy Healthcare Providers, Inc. located?

Legacy Healthcare Providers, Inc. is located at 1272 Center Court Dr Ste. 203, Covina, CA 91724. The listed phone number is (626) 858-5611.

What is Legacy Healthcare Providers, Inc.'s specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Legacy Healthcare Providers, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1009096) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Legacy Healthcare Providers, Inc. was last updated on December 17, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.