Healthcare Provider Details

I. General information

NPI: 1669970737
Provider Name (Legal Business Name): LEGACY TREATMENT SERIVCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 DELSEA DR
FRANKLINVILLE NJ
08322-2306
US

IV. Provider business mailing address

1289 ROUTE 38 STE 203
HAINESPORT NJ
08036-2730
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-5656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE KIRKBRIDE
Title or Position: CEO
Credential:
Phone: 609-267-5656