NPIMap

Organization Active NPI

Legacy Therapeutic Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
National Provider Identifier
1144738188
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LEGACY THERAPEUTIC CENTER LLC
Practice address
4530 S Eastern Ave Ste 1
Las Vegas, NV 89119-6181
Phone
(772) 480-5611
NPI assigned
Jan 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Authorized official

Name
Michael Harrison
Title
Owner
Phone
(772) 480-5611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4530 S Eastern Ave Ste 1
Las Vegas, NV 89119-6181

Mailing address

4530 S Eastern Ave Ste 1
Las Vegas, NV 89119-6181
Phone (772) 480-5611

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1144738188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 S EASTERN AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196181",
            "telephone_number": "772-480-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 S EASTERN AVE STE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196181",
            "telephone_number": "772-480-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY THERAPEUTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-480-5611"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.