| The Legacy Group Foundation, Inc | |
|
210 Vandemere Rd Unit A Bayboro NC 28515-8010 | |
| (910) 340-3630 | |
| (910) 597-1007 |
| Full Name | The Legacy Group Foundation, Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 210 Vandemere Rd Unit A, Bayboro, North Carolina |
| Authorized Official Name and Position | Nicole Denice Barnes (CEO) |
| Authorized Official Contact | 9103403630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Legacy Group Foundation, Inc 8 Carver Rd Jacksonville NC 28540-7010 Ph: (910) 340-3630 | The Legacy Group Foundation, Inc 210 Vandemere Rd Unit A Bayboro NC 28515-8010 Ph: (910) 340-3630 |
| NPI Number | 1033601562 |
|---|---|
| Provider Enumeration Date | 05/31/2018 |
| Last Update Date | 05/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033601562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CSAC-3017 (North Carolina) | Primary |
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