Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Community/Behavioral Health |
251S00000X | |||
Recovery Care |
261QR0800X |
| NPI Number | 1265250393 |
| LBN Legal business name | NEW LEGACY REENTRY CORP |
| Authorized official | GISELA NELSON - (EXECUTIVE DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/27/2024 |
| Last updated | 04/01/2026 - About 2 months ago |
| Identifiers | n/a |
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