Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Treatment Center LLC

Organization Addiction Medicine (Family Medicine) Physician · NPI 1336940717

Legacy Treatment Center LLC is an Addiction Medicine (Family Medicine) Physician in Fort Wayne, Indiana. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3030 Lake Ave Ste 24
Fort Wayne, IN 46805-5428
Phone: (260) 705-4587
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0401X

Record details

NPI number1336940717
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Abdul Barrie — Ceo · (260) 201-3119
NPI enumeratedMarch 21, 2025
Last updated in NPPESDecember 12, 2025
Certification dateDecember 12, 2025
Mailing address3030 Lake Ave Ste 24, Fort Wayne, IN 46805-5428

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