OrganizationActive
Legacy Treatment Center LLC
NPI 1609266642 · Substance Abuse Rehabilitation Facility · Loa, UT
Provider details
- NPI number
- 1609266642
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Troy Faddis, Clinical Director(435) 836-2272
- License
- 11669 (UT)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1764 West Aspen Lane
Loa, UT 84747-0400
Phone: (435) 836-2272
Fax: (435) 836-2274
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 400
Loa, UT 84747-0400
Registry dates
- Enumerated
- 2015-01-29
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.