NPIMap

Organization Active NPI

Legacy Treatment Services Inc

  • Community/Behavioral Health Agency
  • Hainesport, NJ
National Provider Identifier
1730594656
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LEGACY TREATMENT SERVICES INC
Practice address
1289 Route 38
Suite #203
Hainesport, NJ 08036-2730
Phone
(609) 288-3067
Fax
(609) 265-1895
NPI assigned
Jun 30, 2014
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Christine KirkbrideNPI 1659514438
Title
Ceo
Phone
(609) 267-5656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NJ Primary

Addresses

Primary practice location

1289 Route 38
Suite #203
Hainesport, NJ 08036-2730

Mailing address

1289 Route 38
Suite #203
Hainesport, NJ 08036-2730
Phone (609) 288-3067

Other identifiers 1

IdentifierTypeStateIssuer
8847304MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150825003854 NJ Part B Supplier - Clinic/Group Practice 0042526899 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
Practice locations: Hainesport, NJ; Berlin, NJ; Westampton, NJ; Northfield, NJ; Mannington, NJ; Monmouth Junction, NJ

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Union Association of the Childrens Home of Burlington County116 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

561 Tilton Rd
Northfield, NJ 08225
Phone (609) 534-9220

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1730594656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 ROUTE 38",
            "address_2": "SUITE #203",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362730",
            "telephone_number": "609-288-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 ROUTE 38",
            "address_2": "SUITE #203",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362730",
            "telephone_number": "609-288-3067",
            "fax_number": "609-265-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TREATMENT SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "KIRKBRIDE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-267-5656"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8847304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.