Organization
LEGACY TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENRIC JOHN BALORIA (OWNER)
(623) 455-1194
Entity
Organization
Contact information
Practice address
2720 E THOMAS RD SUITE C150, PHOENIX, AZ 85016
(623) 455-1194
Mailing address
2720 E THOMAS RD SUITE C150, PHOENIX, AZ 85016
(623) 455-1194
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2022
Last updated
08/29/2022
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