Legacy Treatment Center LLC

Organization Active
NPI 1336940717
Addiction Medicine (Family Medicine) Physician Fort Wayne, IN

Legacy Treatment Center LLC holds NPI 1336940717, with a primary taxonomy of addiction medicine (family medicine) physician and a practice location in Fort Wayne, IN. The number was issued on March 21, 2025 and the NPPES record was last updated on December 12, 2025.

Taxonomies and licenses

TaxonomyCodeLicense
Addiction Medicine (Family Medicine) Physician Primary 207QA0401X Not listed

Practice location

3030 Lake Ave Ste 24
Fort Wayne, IN 46805-5428
Phone: (260) 705-4587

Local context

Active NPPES records list 5 providers with addiction medicine (family medicine) physician as the primary taxonomy within 25 miles of this practice location's ZIP code.

The same primary taxonomy is listed by 39 in Indiana and 1,636 nationwide.

These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.

Record history

Status
Active
NPI issued
Last updated in NPPES

Is this your record? Updates are made through NPPES, the official National Plan and Provider Enumeration System.

NPPES data as of · Source: CMS NPPES

Building software? Fetch this NPI programmatically with the NPILayer Provider API.

curl
curl -H "Authorization: Bearer YOUR_API_KEY" \
  "https://api.npilayer.com/v1/providers/1336940717"

See the API · Get a free API key