Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LEGACY WELLNESS LLC
NPI 1104735596
Clinic/Center - Rehabilitation, Substance Use Disorder in Edmond, OK

Q: What is Legacy Wellness LLC's NPI number?

The NPI number for Legacy Wellness LLC is 1104735596. It was assigned to this organization in the NPPES registry on September 2, 2026.

Q: What is Legacy Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since September 02, 2026

609 S KELLY AVE BLDG F, EDMOND, OK 73003(949) 522-1469 Get Directions Write a Review

NPPES record added: September 2, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Legacy Wellness Llc NPPES

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

LEGACY WELLNESS LLC (NPI 1104735596) is a healthcare organization registered as a rehabilitation, substance use disorder in Edmond, Oklahoma and active in the NPI registry since September 2026. The organization lists Dolton Beckstead, Cfo, as its authorized official.

NPPES Registry Identity

NPI1104735596

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameLEGACY WELLNESS LLC

Location Address609 S KELLY AVE BLDG FEdmond, OK 73003-5659

Mailing Address609 S Kelly Ave Bldg FEdmond, OK 73003-5659 · (949) 522-1469

Phone(949) 522-1469

Organization SubpartNo

Authorized OfficialDolton BecksteadCfo · (949) 522-1469

Enumeration DateSeptember 2, 2026

NPPES CertifiedSeptember 2, 2026

✔ NPI 1104735596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

609 S KELLY AVE BLDG F, Edmond, OK 73003

Open in Google Maps ↗

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 Wellness LLC's NPI number?

The NPI number for Legacy Wellness LLC is 1104735596. It was assigned to this organization in the NPPES registry on September 2, 2026.

Where is Legacy Wellness LLC located?

Legacy Wellness LLC is located at 609 S Kelly Ave Bldg F, Edmond, OK 73003. The listed phone number is (949) 522-1469.

What is Legacy Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Legacy Wellness LLC was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.