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LEGACY TREATMENT CENTER LLC
NPI 1609266642
Substance Abuse Rehabilitation Facility in Loa, UT

Active since January 29, 2015CLIA 46D2118271 · Waiver
1764 WEST ASPEN LANE, LOA, UT 84747(435) 836-2272(435) 836-2274 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, May 30, 2017 (2 updates tracked since 2017).

About Legacy Treatment Center Llc NPPES

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

LEGACY TREATMENT CENTER LLC (NPI 1609266642) is a healthcare organization registered as a substance abuse rehabilitation facility in Loa, Utah and active in the NPI registry since January 2015. The organization holds a CLIA Waiver certificate valid through September 5, 2026 and lists Troy J Faddis, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1609266642
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameLEGACY TREATMENT CENTER LLC
Location Address1764 WEST ASPEN LANELoa, UT 84747-0400
Mailing AddressPo Box 400Loa, UT 84747-0400 · (435) 836-2272 · Fax (435) 836-2274
Phone(435) 836-2272
Fax(435) 836-2274
Organization SubpartNo
Authorized OfficialTroy J FaddisClinical Director · (435) 836-2272
Enumeration DateJanuary 29, 2015
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1609266642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in UT · 11669
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.
1764 WEST ASPEN LANE, Loa, UT 84747
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2118271

Legacy Treatment Center · Loa, UT
Active · expires Sep 5, 2026
CLIA Number46D2118271
Laboratory TypeResidential Treatment Cen
Certificate Effective DateSeptember 6, 2024
Certificate Expiration DateSeptember 5, 2026
Laboratory DirectorGilbert Hallows
Laboratory Phone(435) 836-2272
Laboratory LocationLegacy Treatment Center1764 W Aspen Lane, Loa, UT 84747
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

STEPHEN KERN LSCSW
Social Worker (Clinical)
1764 WEST ASPEN LANE
LOA, UT 84747
Wayne County (435) 836-2272

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 LLC's NPI number?

The NPI number for Legacy Treatment Center LLC is 1609266642. It was assigned to this organization in the NPPES registry on January 29, 2015.

Where is Legacy Treatment Center LLC located?

Legacy Treatment Center LLC is located at 1764 West Aspen Lane, Loa, UT 84747. The listed phone number is (435) 836-2272.

What is Legacy Treatment Center LLC's specialty?

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

Does Legacy Treatment Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2118271) is associated with this NPI, valid through September 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Legacy Treatment Center LLC accept?

Health plans from University of Utah Health Plans list Legacy Treatment Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Legacy Treatment Center LLC was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.