Legacy Treatment LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

LEGACY TREATMENT LLC

Practice address

109 Cude LN
Madison, TN 37115-2201

Phone

(615) 986-1615

NPI assigned

Apr 1, 2021

Organization subpart

No

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

Authorized official

Name

Nichole MasonNPI 1417656109

Title

Director of Operations

Phone

(615) 986-1615

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Nichole Mason

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, TN
  • NPI 1417656109
  NPD Authorized official
• Darin L. Hale, MD

  • Emergency Medicine Physician
  • Monticello, KY
  • NPI 1760671655
  NPD

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1891373619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CUDE LN",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152201",
            "telephone_number": "615-986-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CUDE LN",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152201",
            "telephone_number": "615-986-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-01",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "615-986-1615"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damisha Antonia Laster
• Anna Lawrence
• Carlton Taylor Leding, DDS
• McKenzie J Lee
• Shannon Lee
• Agnes Diane Leon - Barriera, MD
• Lindsay Jo Leonard, CF-SLP
• Sarah Rose Leonovicz
• David K Lepard, B.A.
• Leta Kant

• Substance Use Disorder Rehabilitation Clinic/Center in Madison, TN
• Providers in Madison, TN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.