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LEGACY TREATMENT CENTER
NPI 1053758102
Substance Abuse Rehabilitation Facility in Charlotte, NC

Active since May 30, 2013
4421 STUART ANDREW BLVD, SUITE 608, CHARLOTTE, NC 28217(561) 715-9288 Get Directions Write a Review

NPPES record last updated: July 11, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Legacy Treatment Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY TREATMENT CENTER (NPI 1053758102) is a healthcare organization registered as a substance abuse rehabilitation facility in Charlotte, North Carolina and active in the NPI registry since May 2013. The organization lists Angela Iacullo, Billing Director, as its authorized official.

NPPES Registry Identity

NPI1053758102
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameLEGACY TREATMENT CENTER
Location Address4421 STUART ANDREW BLVD, SUITE 608Charlotte, NC 28217-1589
Mailing Address4421 Stuart Andrew Blvd, Suite 608Charlotte, NC 28217-1589
Phone(561) 715-9288
Organization SubpartNo
Authorized OfficialAngela IaculloBilling Director · (561) 715-9288
Enumeration DateMay 30, 2013
Last NPPES UpdateJuly 11, 2013
✔ NPI 1053758102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
4421 STUART ANDREW BLVD, Charlotte, NC 28217
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Other Identifiers 1

Other130037NC · North Carolina Department Of Health And Human Services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLEANA CHALIL
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
ASHLEY WARREN SLP
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
PATRICIA WASCO SLP
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
MS. JENNIFER WOODS SLP
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
MARIAH STEWART
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
JENNIFER CAMPBELL DIAZ M. ED., CCC-SLP
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
KAYLEN ALFORD CONNELL M.S.
Speech-Language Pathologist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960
CAMERON MARKS OTD, OTR/L
Occupational Therapist
4421 STUART ANDREW BLVD
CHARLOTTE, NC 28217
Mecklenburg County (980) 343-6960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Treatment Center's NPI number?

The NPI number for Legacy Treatment Center is 1053758102. It was assigned to this organization in the NPPES registry on May 30, 2013.

Where is Legacy Treatment Center located?

Legacy Treatment Center is located at 4421 Stuart Andrew Blvd Suite 608, Charlotte, NC 28217. The listed phone number is (561) 715-9288.

What is Legacy Treatment Center's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Legacy Treatment Center was last updated on July 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.