Organization Active NPI

Legacy Healing and Treatment New Jersey LLC

  • Community/Behavioral Health Agency
  • Cherry Hill, NJ
National Provider Identifier
1417588203
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LEGACY HEALING AND TREATMENT NEW JERSEY LLC
Practice address
800 Kings Hwy N Ste 100
Cherry Hill, NJ 08034-1585
Phone
(609) 267-5656
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Damaris Gonzalez
Title
Director of Operations
Phone
(561) 308-0865

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

800 Kings Hwy N Ste 100
Cherry Hill, NJ 08034-1585

Mailing address

2960 N State Road 7 Ste 101
Margate, FL 33063-5756

Other practice location 1

68 Culver Rd
Monmouth Junction, NJ 08852-2818
Phone (609) 267-1377 ext. 3609

National Provider Directory

National Provider Directory
Tax ID family
Legacy Healing and Treatment New Jersey LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2960 N State Road 7
Ste 101
Margate, FL 33063
Phone (954) 974-3664

68 Culver Rd
Monmouth Junction, NJ 08852
Phone (609) 265-1895

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1417588203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 N STATE ROAD 7 STE 101",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330635756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KINGS HWY N STE 100",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341585",
            "telephone_number": "609-267-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Culver Rd",
            "address_purpose": "LOCATION",
            "city": "Monmouth Junction",
            "state": "NJ",
            "postal_code": "088522818",
            "country_code": "US",
            "telephone_number": "609-267-1377 x3609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY HEALING AND TREATMENT NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DAMARIS",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "561-308-0865"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.