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CHC07502-30 LEGACY COMMUNITY HEALTH SERVICES, INC. (Terminated)
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Main Details
Name
LEGACY COMMUNITY HEALTH SERVICES, INC.
Subdivision Name
Legacy San Jacinto Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019129
340B ID
CHC07502-30
Grant Number
H80CS07502
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/11/2017
Last Recertification Date
2/2/2023
Termination Date
Termination Reason
1/1/2024
Site closure
Contacts
Authorizing Official
Legacy Community Health Services, Inc.
Robert Hilliard, CEO
(832) 548-5277
Primary Contact
Legacy Community Health Services
Delayna Judy, VP of Accounting
(832) 548-5083
Addresses
Street Address
4301 Garth Rd Ste. 302
Baytown, TX 77521-7752
Billing Address
Legacy Community Health Services
PO Box 66308
Houston, TX 77266
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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