OrganizationActive
Legendary Support Coordination
NPI 1629638838 · Supports Brokerage Agency · Woodbury Heights, NJ
Legendary Support Coordination is a Supports Brokerage Agency organization in Woodbury Heights, NJ (NPI 1629638838).
Provider details
- NPI number
- 1629638838
- Entity type
- Organization
- Primary specialty
- Supports Brokerage AgencyAgencies
- Organization subpart
- No
- Authorized official
- Kaseim Ezell, Co-Owner(215) 696-2300
Specialties & taxonomies
Agencies
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
136 Queen Ave
Woodbury Heights, NJ 08097-1635
Phone: (215) 696-2300
Street-level locationGet directions
Mailing address
3908 Montella Cir
Collegeville, PA 19426-1217
Registry dates
- Enumerated
- 2019-06-19
- Last updated
- 2019-06-19
Frequently asked questions
- What is Legendary Support Coordination's NPI number?
- Legendary Support Coordination's National Provider Identifier (NPI) is 1629638838, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Legendary Support Coordination?
- Legendary Support Coordination is classified in the NPPES registry as Supports Brokerage Agency (Agencies).
- Where is Legendary Support Coordination located?
- Legendary Support Coordination's practice location on file with NPPES is 136 Queen Ave, Woodbury Heights, NJ 08097-1635.
- What is Legendary Support Coordination's phone number?
- The practice phone number listed in the NPPES registry for Legendary Support Coordination is (215) 696-2300.
- Who is the authorized official for Legendary Support Coordination?
- The authorized official listed on Legendary Support Coordination's NPPES record is Kaseim Ezell, Co-Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Legendary Support Coordination's NPI active?
- Yes — Legendary Support Coordination's NPI (1629638838) is active in the NPPES registry as of the last update on 2019-06-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.