| NPI | 1043924632 |
|---|---|
| Doing Business As | NEW LEGACY TREATMENT CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | AIMABLE SEBA BYISHIMO CAO 319-202-2573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |