Organization
LEGACY TREATMENT LLC
Active
Parent organization
LEGACY TREATMENT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY TREATMENT LLC
Authorized official
LLOYD A WYNN (COO)
(973) 558-8514
Entity
Organization
Contact information
Practice address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-4491
(410) 728-5729
Mailing address
4432 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6315
(410) 728-4491
(410) 728-5729
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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