LEGACY TREATMENT CENTER (NPI# 1578904603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578904603 |
| Entity Type | Organization |
| Organization Name | LEGACY TREATMENT CENTER |
| Practice Address |
4421 Stuart Andrew Blvd Suite 608 Charlotte NC 28217-1589 |
| Practice Telephone | 7044050908 |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |
| Authorized Official Name | ANGELA IACULLO (DIRECTOR) |
| Authorized Official Telephone | 5617159288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 34D2055755 | NC | Laboratories |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730567033 | Legacy Treatment Center | Substance Abuse Rehabilitation Facility | 5401 New Centre Drive, Suite 200, Wilmington, NC 28403 | 2015-05-07 |
| 1053758102 | Legacy Treatment Center | Substance Abuse Rehabilitation Facility | 4421 Stuart Andrew Blvd, Suite 608, Charlotte, NC 28217-1589 | 2013-05-30 |
| 1700289642 | Legacy Treatment Center | Substance Abuse Rehabilitation Facility | 3824 Barrett Dr, Suite 310, Raleigh, NC 27609-7220 | 2014-10-07 |
| Street Address |
4421 STUART ANDREW BLVD SUITE 608 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-1589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053758102 | Legacy Treatment Center | Substance Abuse Rehabilitation Facility | 4421 Stuart Andrew Blvd, Suite 608, Charlotte, NC 28217-1589 | 2013-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341006 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 125 Queens Rd Ste 370, Charlotte, NC 28204-3215 | 2020-09-17 |
| 1538716113 | Karany's Veracity Company,llc | Clinical Medical Laboratory | 1816 E Arbors Dr Ste 440, Charlotte, NC 28262-2666 | 2019-08-20 |
| 1720546468 | Southeast Pathology Consultants, Inc. | Clinical Medical Laboratory | 1815 Back Creek Dr Ste 100, Charlotte, NC 28213-2159 | 2019-03-12 |
| 1679060222 | 1st Stop Labs LLC | Clinical Medical Laboratory | 4920 Albemarle Rd, Charlotte, NC 28205-6618 | 2018-04-19 |
| 1700399656 | David Farache | Clinical Medical Laboratory | 300 Billingsley Rd Ste 107, Charlotte, NC 28211-1084 | 2017-11-14 |
| 1063945582 | Bpolloni Consulting | Clinical Medical Laboratory | 11709 Fruehauf Drive, Suite 105 & 106, Charlotte, NC 28273 | 2017-04-11 |
| 1639541295 | Highline Labs, LLC | Clinical Medical Laboratory | 5900 Northwoods Business Parkway, Suite K, Charlotte, NC 28269-5747 | 2015-10-22 |
| 1134512429 | Anchore Laboratories, Inc | Clinical Medical Laboratory | 3635 Mount Holly Huntersville Rd, Charlotte, NC 28216-8628 | 2015-03-10 |
| 1326430091 | Captiva Lab | Clinical Medical Laboratory | 3300 International Airport Drive, Suite 100, Charlotte, NC 28208-5799 | 2015-03-04 |
| 1578960274 | Direct Access Lab, LLC | Clinical Medical Laboratory | 4822 Albemarle Road, Suite 110, Charlotte, NC 28205-6621 | 2014-11-24 |
| Find all providers in CHARLOTTE | ||||
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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.