Organization
THE LEGACY GROUP FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DENICE BARNES CSAC (CEO)
(910) 340-3630
Entity
Organization
Contact information
Practice address
210 VANDEMERE RD UNIT A, BAYBORO, NC 28515-8010
(910) 340-3630
(910) 597-1007
Mailing address
8 CARVER RD, JACKSONVILLE, NC 28540-7010
(910) 340-3630
(910) 597-1007
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSAC-3017
NC
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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