Organization
LEGACY THERAPEUTIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HARRISON (OWNER)
(772) 480-5611
Entity
Organization
Contact information
Practice address
4530 S EASTERN AVE STE 1, LAS VEGAS, NV 89119-6181
(772) 480-5611
Mailing address
4530 S EASTERN AVE STE 1, LAS VEGAS, NV 89119-6181
(772) 480-5611
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/11/2018
Last updated
01/11/2018
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