Organization
LEGACY TREATMENT CENTER LLC
Active
Organization
LEGACY TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABDUL BARRIE (CEO)
(260) 201-3119
Entity
Organization
Contact information
Practice address
3030 LAKE AVE STE 24, FORT WAYNE, IN 46805-5428
(260) 705-4587
Mailing address
3030 LAKE AVE STE 24, FORT WAYNE, IN 46805-5428
(260) 705-4587
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
03/21/2025
Last updated
12/12/2025
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