MEDICARE: LEGACY TREATMENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility

General Provider Information

NPI Number	:	1215880331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY TREATMENT SERVICES

Provider Business Mailing Address
First Line	:	1289 ROUTE 38 STE 203
Second Line	:
City	:	HAINESPORT
State	:	NJ
Zip	:	08036-2730
Country	:	US
Telephone Number	:	215-750-4244
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 CHURCH RD
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-2206
Country	:	US
Telephone Number	:	800-433-7365
Fax Number	:

Authorized Official
Title or Position	:	VP OF ADMINISTRATION
Name	:	MARY E ANGELINI
Credential	:
Telephone Number	:	215-750-4244

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

Similar Medicare Providers

1184122392 — COMMUNITY TREATMENT SOLUTIONS
Practice Location Address:

4306 CHURCH RD
MOUNT LAUREL, NJ
08054-2206

Practice Phone: 856-642-9090
Practice Fax:

1003894213 — MR. CURTIS NATHANIEL SMITH SR. MD
Practice Location Address:

110 W CASTLE ST , SUITE 200
MOUNT SHASTA, CA
96067-2206

Practice Phone: 530-926-4401
Practice Fax: 530-926-3791

1508999731 — GERALDINE G MCGRADY LPTA
Practice Location Address:

2206 RIDGE CREST LN
MOUNT AIRY, NC
27030-2483

Practice Phone: 336-786-9132
Practice Fax: 336-786-9153

1336273945 — GENESIS
Practice Location Address:

2206 RIDGE CREST LN
MOUNT AIRY, NC
27030-2483

Practice Phone: 336-786-9132
Practice Fax:

1417071549 — DARLA L JEFFERSON LPTA
Practice Location Address:

2206 RIDGE CREST LN
MOUNT AIRY, NC
27030-2483

Practice Phone: 336-786-9132
Practice Fax: 336-786-9153

1699893081 — MARVIN BERNARD KAYE LPT
Practice Location Address:

2206 RIDGE CREST LN
MOUNT AIRY, NC
27030-2483

Practice Phone: 336-786-9132
Practice Fax: 336-786-9153

Directions to “LEGACY TREATMENT SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.