NPIMap

Organization Active NPI

Legacy Treatment LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sykesville, MD
National Provider Identifier
1417422965
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LEGACY TREATMENT LLC
Practice address
1438 Liberty Rd
Sykesville, MD 21784
Phone
(443) 609-4302
Fax
(443) 609-4625
NPI assigned
Oct 11, 2018
Organization subpart
Yes
Parent organization
LEGACY TREATMENT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Lloyd A Wynn
Title
Coo
Phone
(973) 558-8514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1438 Liberty Rd
Sykesville, MD 21784

Mailing address

1438 Liberty Rd
Sykesville, MD 21784-6493
Phone (443) 609-4602

National Provider Directory

National Provider Directory
Tax ID family
Legacy Treatment LLC4 organizations share this tax ID, including this one
Part of
Legacy Treatment LLC

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1417422965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 LIBERTY RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846493",
            "telephone_number": "443-609-4602",
            "fax_number": "443-609-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 LIBERTY RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "21784",
            "telephone_number": "443-609-4302",
            "fax_number": "443-609-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TREATMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY TREATMENT LLC",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "973-558-8514"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sykesville, MD

Sources for this page

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