# LEGACY RECOVERY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477993814
- **Authorized official:** ELIJAH JACQUES LCDC-I (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (713) 636-2964

## Contact information

- **Practice address:** 388 W LITTLE YORK RD, HOUSTON, TX 77076-1303
- **Practice address phone:** (713) 636-2964
- **Practice address fax:** (713) 636-9686
- **Mailing address:** PO BOX 3342, SPRING, TX 77383-3342
- **Mailing address phone:** (713) 636-2964
- **Mailing address fax:** (713) 636-9686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | 10734 | TX | — |
| 261QM0850X | Adult Mental Health Clinic/Center | 10734 | TX | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 10734 | TX | — |
| 261QM1300X | Multi-Specialty Clinic/Center | 10734 | TX | — |
| 261QR0400X | Rehabilitation Clinic/Center | 10734 | TX | — |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | 10734 | TX | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | 10734 | TX | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | 3648-3655 | TX | — |

## Other

- **Enumeration date:** 06/30/2013
- **Last updated:** 03/24/2015