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LEGACY HUMAN SERVICES, INC.
NPI 1912176603
Custodial Care Facility - Adult Care Home in Henderson, NC

Active since February 27, 2008
264 S BECKFORD DR, ROANOKE AVENUE GROUP HOME, HENDERSON, NC 27536(252) 438-7060(252) 438-6720 Get Directions Write a Review

NPPES record last updated: September 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 10, 2021, Nov 26, 2018 (2 updates tracked since 2018).

About Legacy Human Services, Inc. NPPES

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

LEGACY HUMAN SERVICES, INC. (NPI 1912176603) is a healthcare organization registered as an adult care home in Henderson, North Carolina and active in the NPI registry since February 2008. The organization lists Jacinta Johnson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1912176603
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameLEGACY HUMAN SERVICES, INC.
Location Address264 S BECKFORD DR, ROANOKE AVENUE GROUP HOMEHenderson, NC 27536-2564
Mailing AddressPo Box 88Henderson, NC 27536-0088 · (252) 438-6700 · Fax (252) 438-6720
Phone(252) 438-7060
Fax(252) 438-6720
Organization SubpartNo
Authorized OfficialJacinta JohnsonExecutive Director · (252) 438-6700
Enumeration DateFebruary 27, 2008
Last NPPES UpdateSeptember 10, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2021
✔ NPI 1912176603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in NC · MHL-091-002
Definition
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.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320900000X · License MHL-091-061 (NC)
264 S BECKFORD DR, Henderson, NC 27536
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Other Identifiers 1

Medicaid7805492NC

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 Human Services, Inc.'s NPI number?

The NPI number for Legacy Human Services, Inc. is 1912176603. It was assigned to this organization in the NPPES registry on February 27, 2008.

Where is Legacy Human Services, Inc. located?

Legacy Human Services, Inc. is located at 264 S Beckford Dr Roanoke Avenue Group Home, Henderson, NC 27536. The listed phone number is (252) 438-7060.

What is Legacy Human Services, Inc.'s specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Legacy Human Services, Inc. was last updated on September 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.