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Organization
LEGACY TREATMENT LLC
Active
Organization
LEGACY TREATMENT LLC
Active
Parent organization
LEGACY TREATMENT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY TREATMENT LLC
Authorized official
LLOYD A WYNN (COO)
(973) 558-8514
Entity
Organization
Contact information
Practice address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-4491
(410) 728-5729
Mailing address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-4491
(410) 728-5729
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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