LEGACY TREATMENT CENTER NPI 1700289642

NPI Information

NPI: 1700289642
Provider Name: LEGACY TREATMENT CENTER
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
3824 BARRETT DR
SUITE 310
RALEIGH, NC
ZIP 27609
Phone: (954) 560-5238
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LEGACY TREATMENT CENTER is a substance abuse rehabilitation facility in Raleigh, NC. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. LEGACY TREATMENT CENTER NPI is 1700289642. The provider is registered as an organization entity type.

The provider's business location address is:

3824 BARRETT DR
SUITE 310
RALEIGH, NC
ZIP 27609-220
Phone: (954) 560-5238
Fax: (888) 510-9071

The provider's authorized official is Brad Wilkerson .
The authorized official title is Ceo and has the following contact phone number (954) 560-5238.

The enumeration date for this NPI number is 10/7/2014 and was last updated on 10/7/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		MHL-060-1265	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MHL-060-1265	OTHER	NORTH CAROLINA	NC STATE LICENSE
2	34D2054739	OTHER	NORTH CAROLINA	CLIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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