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1912664509
LEGACY 4 CHANGE
JACKSON, MS
NPI
1912664509
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Entity Type
Organization
Authorized Contact
CHASITY DAVIS
President
769-203-8141
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
Enumeration Date
2021-11-18
Last Update Date
2022-01-20
Business Address
LEGACY 4 CHANGE
2891 TERRY RD
JACKSON, MS 39212-3051
Phone number: 769-203-8141
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Mailing Address
LEGACY 4 CHANGE
PO BOX 821878
VICKSBURG, MS 39182-1878
Phone number: 769-203-8141
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