LEGACY TREATMENT LLC (NPI# 1912472473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912472473 |
| Entity Type | Organization |
| Organization Name | LEGACY TREATMENT LLC |
| Practice Address |
4432 Park Heights Ave Baltimore MD 21215-6315 |
| Mailing Address |
826 Hollins St Unit 1 Baltimore MD 21201-1004 |
| Practice Telephone | 4107284491 |
| Practice Fax Number | 4107285729 |
| Mailing Telephone | 9735588514 |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | LLOYD A WYNN (COO) |
| Authorized Official Telephone | 9735588514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1438 Liberty Rd Ste 3&4, Sykesville, MD 217846493 | 4436094302 | 4434094625 |
| 8610 Washington Blvd Ste 200, Jessup, MD 207949499 | 4108248149 | 4108248371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952877219 | Legacy Treatment LLC | Counselor | 4432 Park Heights Ave, Baltimore, MD 21215-6315 | 2018-10-15 |
| 1417422965 | Legacy Treatment LLC | Clinic/Center | 1438 Liberty Rd, Sykesville, MD 21784 | 2018-10-11 |
| 1841765393 | Legacy Treatment LLC | Counselor | 8610 Washington Blvd, Jessup, MD 20794-9499 | 2018-10-11 |
| Street Address |
4432 PARK HEIGHTS AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-6315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801948070 | I Can't - We Can, Inc. | Counselor | 4432 Park Heights Ave, Baltimore, MD 21215-6324 | 2007-01-17 |
| 1952877219 | Legacy Treatment LLC | Counselor | 4432 Park Heights Ave, Baltimore, MD 21215-6315 | 2018-10-15 |
| 1710409305 | I Cant-we Can Counseling Center LLC | Clinical Medical Laboratory | 4432 Park Heights Ave, Baltimore, MD 21215-6315 | 2017-07-14 |
| 1639538739 | I Can't We Can Counseling Center | Community Based Residential Treatment Facility, Mental Illness | 4432 Park Heights Ave, Baltimore, MD 21215-6315 | 2016-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1851998892 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 2fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
| 1275148975 | Hel Recovery Center | Clinic/Center | 1900 N Howard St Fl 2, Baltimore, MD 21218-5909 | 2020-09-10 |
| 1497365654 | Inspiring Change Mental Health Services, LLC. | Clinic/Center | 4654 York Rd Ste 1, Baltimore, MD 21212-4726 | 2020-08-03 |
| 1174132518 | Sabinas House LLC | Clinic/Center | 3103 Mareco Ave, Baltimore, MD 21213-1619 | 2020-07-30 |
| 1134738909 | Sabinas House LLC | Clinic/Center | 2224 Dukeland St, Baltimore, MD 21216-2812 | 2020-07-28 |
| 1881203792 | Sabinas House LLC | Clinic/Center | 3325 Shannon Dr, Baltimore, MD 21213-1823 | 2020-07-27 |
| 1356950265 | Sabinas House LLC | Clinic/Center | 616 Wildwood Pkwy, Baltimore, MD 21229-1810 | 2020-07-27 |
| 1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.