Organization
LEGACY TREATMENT CENTER LLC
Active
Organization
LEGACY TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY J FADDIS LMFT (CLINICAL DIRECTOR)
(435) 836-2272
Entity
Organization
Contact information
Practice address
1764 WEST ASPEN LANE, LOA, UT 84747-0400
(435) 836-2272
(435) 836-2274
Mailing address
PO BOX 400, LOA, UT 84747-0400
(435) 836-2272
(435) 836-2274
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
11669
UT
Other
Enumeration date
01/29/2015
Last updated
07/21/2022
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