NPIMap

Organization Active NPI

Legacy Recovery

  • Mental Illness Community Based Residential Treatment Facility
  • Baton Rouge, LA
National Provider Identifier
1003167446
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
507 Issued in LA
Legal business name
LEGACY RECOVERY
Practice address
168 W Washington St
Baton Rouge, LA 70802-7655
Phone
(225) 300-8091
Fax
(225) 302-7462
NPI assigned
Sep 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Adell Ellis
Title
Executive Director
Phone
(225) 300-8091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 507 LA Primary

Addresses

Primary practice location

168 W Washington St
Baton Rouge, LA 70802-7655

Mailing address

168 W Washington St
Baton Rouge, LA 70802-7655
Phone (225) 300-8091

Other identifiers 1

IdentifierTypeStateIssuer
507OtherLASTATE LICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1003167446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 W WASHINGTON ST",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708027655",
            "telephone_number": "225-300-8091",
            "fax_number": "225-302-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 W WASHINGTON ST",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708027655",
            "telephone_number": "225-300-8091",
            "fax_number": "225-302-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ADELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-300-8091",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "LA",
            "license": "507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "507",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.