LEGACY TREATMENT SERVICES (NPI# 1396128955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396128955 |
| Entity Type | Organization |
| Organization Name | LEGACY TREATMENT SERVICES |
| Practice Address |
610 Pemberton Browns Mills Rd Pemberton NJ 08068-1537 |
| Mailing Address |
1289 Route 38 West Suite #203 Hainesport NJ 08036-2730 |
| Practice Telephone | 6092883067 |
| Practice Fax Number | 6092651895 |
| Mailing Telephone | 6092883067 |
| Mailing Fax Number | 6092651895 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | BETTY GARRISON (CFO) |
| Authorized Official Telephone | 6092883067 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | NJ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922557727 | Legacy Treatment Services | Community/Behavioral Health | 5602 Kirkwood Highway, Wilmington, DE 19808 | 2016-09-22 |
| 1730557448 | Legacy Treatment Services | In Home Supportive Care | 243 Pine Street, Mount Holly, NJ 08060 | 2015-09-11 |
| 1659755668 | Legacy Treatment Services | Community/Behavioral Health | 119 Creek Rd, Lumberton, NJ 08048-5229 | 2015-07-20 |
| 1518363316 | Legacy Treatment Services | Community/Behavioral Health | 110 Old Turnpike Road, Oldwick, NJ 08858 | 2014-11-06 |
| 1316342553 | Legacy Treatment Services | Community/Behavioral Health | 74 Hawkin Rd, New Egypt, NJ 08533-2824 | 2014-10-30 |
| 1942605183 | Legacy Treatment Services | Community/Behavioral Health | 553 Monmouth Rd, Wrightstown, NJ 08562-2125 | 2014-10-30 |
| 1841673407 | Legacy Treatment Services | Community/Behavioral Health | 795 Woodlane Rd, Suite #301, Westampton, NJ 08060-3832 | 2015-07-01 |
| 1881085637 | Legacy Treatment Services | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-02-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEGACY TREATMENT SERVICES | 3837 Mayfair St, Pittsburgh, PA 15204-1011 |
| System for Award Management (SAM) Entities | LEGACY TREATMENT SERVICES, INC | 1289 Route 38 Ste 203, Hainesport, NJ 08036-2730 |
| Street Address |
610 PEMBERTON BROWNS MILLS RD |
| City | PEMBERTON |
| State | NJ |
| Zip Code | 08068-1537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154643500 | Phyllis Glenn Anderson | Nurse Practitioner | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2010-02-25 |
| 1710593579 | Jeana Ann Simko | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2020-09-17 |
| 1457851107 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2018-02-20 |
| 1306346325 | Maryville, Inc | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068 | 2018-02-16 |
| 1881085637 | Legacy Treatment Services | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2015-02-16 |
| 1962800367 | Orin H Morrison Jr. | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-12-17 |
| 1790180438 | Kevin Ford | Counselor | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-10-23 |
| 1376944967 | Union Association of The Children's Home of Burlington County, Inc. | Clinic/Center | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-09-15 |
| 1881093920 | Union Assocation of The Children's Home of Burlington County, Inc. | Community/Behavioral Health | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2014-08-14 |
| 1902180037 | The Kintock Group of New Jersey, Inc. | Substance Abuse Rehabilitation Facility | 610 Pemberton Browns Mills Rd, Pemberton, NJ 08068-1537 | 2011-10-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366998502 | Deena Gutch | Counselor | 610 Brownsmills Rd, Pemberton, NJ 08068 | 2016-08-28 |
| 1467738492 | Exceptional Kidz Rehabilitation | Counselor | 43 Elizabeth St, Pemberton, NJ 08068 | 2011-10-21 |
| 1972716603 | Ellen Christine Miller | Occupational Therapy Assistant | 600 Pemberton Browns-mills Road, Pemberton, NJ 08068 | 2007-05-08 |
| 1720236631 | Renuka Maringanti | Dentist | 600 Pemberton Browns Mills Rd, Pemberton, NJ 08068 | 2008-09-04 |
| 1053453076 | Chitra Sarvotam | Dentist | 600 Pemberton-browns Mills Road, Pemberton, NJ 08068 | 2007-02-13 |
| 1700182847 | E Estrella Wells | Student in an Organized Health Care Education/Training Program | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2011-02-08 |
| 1417339128 | Jamie Reuter | Behavioral Analyst | 50 Budd Ave, Pemberton, NJ 08068-1104 | 2015-06-18 |
| 1710167614 | Stephen Alan Kloss | Pharmacist | 87 Hanover St, Pemberton, NJ 08068-1131 | 2007-11-07 |
| 1639291248 | Pemberton Township School District | Local Education Agency (LEA) | 1 Egbert St, Pemberton, NJ 08068-1211 | 2007-04-04 |
| 1851635791 | Aspired Living, Inc | Day Training, Developmentally Disabled Services | 43 Elizabeth St, Pemberton, NJ 08068-1215 | 2012-11-15 |
| Find all providers in zip 08068 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
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| 1194354407 | Recover Physical Therapy | Clinic/Center | 1501 Old Black Horse Pike Apt F9, Blackwood, NJ 08012-4927 | 2020-04-07 |
| 1154950657 | Real House Inc. | Clinic/Center | 1089-91 East Jersey Street, Elizabeth, NJ 07201 | 2020-04-06 |
| 1205464823 | Fulcrum Performance Lab, LLC | Clinic/Center | 75 S Maple Ave, Marlton, NJ 08053-2032 | 2020-03-30 |
| 1215563887 | Dr Cloyd's Clinical Psychology and Neuropsychology Practice Pllc | Clinic/Center | 1209 Route 70 W, Cherry Hill, NJ 08002-3532 | 2020-03-16 |
| 1144860271 | Sentarus Healthcare Solutions Inc | Clinic/Center | 736 S White Horse Pike, Audubon, NJ 08106-1346 | 2020-01-07 |
| 1497303044 | Sanni Ojibara Training Academy | Clinic/Center | 104 Hillside Ter, Irvington, NJ 07111-1514 | 2019-08-27 |
| 1457907404 | Vitality Wellness Group LLC | Clinic/Center | 1000 Sanger Ave Ste 211, Oceanport, NJ 07757-1241 | 2019-08-15 |
| 1760034292 | Optimally Nourished LLC | Clinic/Center | 303 Belmont Ave Ste 2, Belleville, NJ 07109-1103 | 2019-07-15 |
| 1881246676 | Acenda, Inc. | Clinic/Center | 1129 Route 9 S, Cape May Court House, NJ 08210-2752 | 2019-07-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.