NPIMap

Organization Active NPI

Legacy Freedom Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Charlotte, NC
National Provider Identifier
1063860666
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
MHL0601265 Issued in NC
Legal business name
LEGACY FREEDOM TREATMENT CENTER
Practice address
4944 Parkway Plaza Blvd
Suite 300
Charlotte, NC 28217-1972
Phone
(954) 560-5238
Fax
(888) 510-9071
NPI assigned
May 25, 2016
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Denise Melendez
Title
Director
Phone
(954) 560-5238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X MHL0601265 NC Primary

Addresses

Primary practice location

4944 Parkway Plaza Blvd
Suite 300
Charlotte, NC 28217-1972

Mailing address

445 Dolley Madison Rd
Greensboro, NC 27410-5165
Phone (954) 560-5238

Other identifiers 1

IdentifierTypeStateIssuer
MHL0601265OtherNCSTATE LICENSE

Other names 1

  • LEGACY TREATMENT CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Legacy Freedom Treatment Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4944 Parkway Plaza Blvd
Ste 300
Charlotte, NC 28217
Phone (704) 930-2456

445 Dolley Madison Rd
Greensboro, NC 27410

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1063860666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 DOLLEY MADISON RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274105165",
            "telephone_number": "954-560-5238",
            "fax_number": "888-510-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4944 PARKWAY PLAZA BLVD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171972",
            "telephone_number": "954-560-5238",
            "fax_number": "888-510-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY FREEDOM TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "MELENDEZ",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-560-5238"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NC",
            "license": "MHL0601265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MHL0601265",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEGACY TREATMENT CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.