Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Legacy Residential Program

Organization Case Management Agency · NPI 1003506171

Legacy Residential Program is a Case Management Agency in Philadelphia, Pennsylvania. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
8
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Practice location Address checks out

2156 N 30th St
Philadelphia, PA 19121-1101
Phone: (267) 315-5124
Fax: (267) 324-3106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Management Agency (primary) Taxonomy 251B00000X
Assisted Living Facility (Mental Illness) Taxonomy 3104A0625X
Intellectual Disabilities Intermediate Care Facility Taxonomy 315P00000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility Taxonomy 320600000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X
Psychiatric Residential Treatment Facility Taxonomy 323P00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X

Record details

NPI number1003506171
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ashley Edwards — Ceo · (215) 397-7823
Other names House Of Lilies
NPI enumeratedMay 11, 2023
Last updated in NPPESMay 11, 2023
Certification dateMay 11, 2023
Mailing address8480 Limekiln Pike Ph 5, Wyncote, PA 19095-2816

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