LEGACY VALLEY ADDICTION TREATMENT
NPI 1366240301
Clinic/Center - Mental Health (Including Community Mental Health Center) in Victorville, CA
About Legacy Valley Addiction Treatment NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEGACY VALLEY ADDICTION TREATMENT (NPI 1366240301) is a healthcare organization registered as a mental health (including community mental health center) in Victorville, California and active in the NPI registry since March 2025. The organization lists Angela L Abbott, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Legacy Valley Addiction Treatment is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Legacy Valley Addiction Treatment, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Valley Addiction Treatment's NPI number?
The NPI number for Legacy Valley Addiction Treatment is 1366240301. It was assigned to this organization in the NPPES registry on March 5, 2025.
Where is Legacy Valley Addiction Treatment located?
Legacy Valley Addiction Treatment is located at 16519 Victor St Ste 302, Victorville, CA 92395. The listed phone number is (760) 305-9677.
What is Legacy Valley Addiction Treatment's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Legacy Valley Addiction Treatment enrolled in Medicare?
Yes. Legacy Valley Addiction Treatment is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Legacy Valley Addiction Treatment?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Marriage and Family Therapist) reassigns their Medicare billing to Legacy Valley Addiction Treatment. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Legacy Valley Addiction Treatment was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Legacy Valley Addiction Treatment · NPI 1366240301
Mental Health (Including Community Mental Health Center) organization in Victorville, California. Organization record, active in the CMS NPPES registry since March 5, 2025.
## Identity
- **NPI:** 1366240301 (Entity type: Organization)
- **Enumerated:** March 5, 2025
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Angela Abbott, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 16519 VICTOR ST STE 302, Victorville, CA 92395-3967
- **Phone:** (760) 305-9677
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Marriage and Family Therapist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1366240301) · Data from the CMS NPPES public registry.