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General NPI Number Information
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NPI Number | 1053268029
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Entity Type | Organization
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Legal Business Name | LEGACY RECOVERY & WELLNESS
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 21190 CHRISTANNA HWY
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868-2509
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Country | US
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Telephone | 434-532-7712
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N HILLS DR
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868-3019
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Country | US
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Telephone | 434-532-7712
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LARRY LEWIS
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Credential |
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Telephone | 434-532-7712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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