Healthcare Provider Details

I. General information

NPI: 1790551299
Provider Name (Legal Business Name): LEGACY TREATMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1289 ROUTE 38 STE 203
HAINESPORT NJ
08036-2730
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: 609-265-1895
Mailing address:
  • Phone: 609-267-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

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