Legacy Treatment Center LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

LEGACY TREATMENT CENTER LLC

Practice address

3030 Lake Ave Ste 24
Fort Wayne, IN 46805-5428

Phone

(260) 705-4587

NPI assigned

Mar 21, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Abdul Barrie

Title

Ceo

Phone

(260) 201-3119

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Rose Barrie, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1497308852
  Medicare reassignment Care Compare group NPD
• Kathleen Vanderreyden, NP

  • Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1225668312
  Medicare reassignment Care Compare group NPD
• Laury Farrell, FNP

  • Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1891394599
  Medicare reassignment NPD

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1336940717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 LAKE AVE STE 24",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055428",
            "telephone_number": "260-705-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LAKE AVE STE 24",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055428",
            "telephone_number": "260-705-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "BARRIE",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-201-3119",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Leffers, FNP
• Kevin John Leffers, MD
• Pamela Leffers
• Legacy Dental LLC
• Legacy Healthcare Services, Inc
• Legoras Conture Fashions
• Aaron Lehman, NP-C
• Breanna Leigh Lehman, MS, LAT, ATC
• Cathy Jeanene Lehman, M.A., CCC-SLP
• Charlene Rene Lehman, LCSW

• Addiction Medicine (Family Medicine) Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Addiction Medicine (Family Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.