LEGENDARY SUPPORT COORDINATION
NPI 1629638838
Supports Brokerage in Woodbury Heights, NJ

Active since June 19, 2019
136 QUEEN AVE, WOODBURY HEIGHTS, NJ 08097(215) 696-2300 Get Directions Write a Review

NPPES record last updated: June 19, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Legendary Support Coordination NPPES

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

LEGENDARY SUPPORT COORDINATION (NPI 1629638838) is a healthcare organization registered as a supports brokerage in Woodbury Heights, New Jersey and active in the NPI registry since June 2019. The organization lists Kaseim Ezell, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1629638838
Entity TypeOrganization
Primary Taxonomy251X00000X
Legal Business NameLEGENDARY SUPPORT COORDINATION
Location Address136 QUEEN AVEWoodbury Heights, NJ 08097-1635
Mailing Address3908 Montella CirCollegeville, PA 19426-1217 · (215) 696-2300
Organization SubpartNo
Authorized OfficialKaseim EzellCo-owner · (215) 696-2300
Enumeration DateJune 19, 2019
NPI 1629638838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySupports BrokerageAgencies
Taxonomy Code251X00000X
Definition
A provider of service/function that assists participating individuals to make informed decisions about what will work best for them is consistent with their needs and reflects their individual circumstances. Serving as the agent of the individual, the service is available to assist in identifying immediate and long-term needs, developing options to meet those needs and accessing identified supports and services and may include assistance with recruiting, screening, hiring, and training in-home support providers. A family or person-centered planning approach is used. Supports Brokerage offers practical skills training to enable families and individuals to remain independent. Examples of skills training include providing information on recruiting and hiring personal care workers, managing personal care workers and providing information on effective communication and problem solving. The service/function provides sufficient information to assure that individuals understand the responsibilities involved with self-direction and assist in the development of an effective back-up and emergency plan. Plans may elect to fulfill the requirement of this service/function using a self-directed case manager or creating a distinct service. The Supports Brokerage documents the need for assistive services, planning for and documenting the use of excess funds and locating and maintaining services.
136 QUEEN AVE, Woodbury Heights, NJ 08097

Other Providers at the Same Location NPPES

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

Home Health
136 QUEEN AVE
WOODBURY HEIGHTS, NJ 08097

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 Legendary Support Coordination's NPI number?

The NPI number for Legendary Support Coordination is 1629638838. It was assigned to this organization in the NPPES registry on June 19, 2019.

Where is Legendary Support Coordination located?

Legendary Support Coordination is located at 136 Queen Ave, Woodbury Heights, NJ 08097. The listed phone number is (215) 696-2300.

What is Legendary Support Coordination's specialty?

The primary specialty registered for this NPI is Supports Brokerage with taxonomy code 251X00000X.

When was this NPI record last updated?

The NPPES record for Legendary Support Coordination was last updated on June 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.