Legacy Residential Program
Substance Abuse Rehabilitation Facility in Philadelphia, Pennsylvania
NPI 1003506171
Legacy Residential Program is a Substance Abuse Rehabilitation Facility based in Wyncote, PA. Legacy Residential Program practices in Philadelphia, PA. The NPI Number for Legacy Residential Program is 1003506171 and holds a License No. (Pennsylvania).
The current practice location address for Legacy Residential Program is 2156 N 30Th St, Philadelphia, PA and can be reached out via phone at 267-315-5124 and via fax at 267-324-3106. You can also correspond with Legacy Residential Program through the mailing address at 8480 LIMEKILN PIKE PH 5, WYNCOTE, PA - 19095-2816 (mailing address contact number: 267-315-5124).
Location: 2156 N 30Th St, Philadelphia, PA, 19095-2816
Provider Profile Details
NPI Number
1003506171
Provider Name
Legacy Residential Program
Credential
Provider Entity Type
Organization
Address
2156 N 30Th St, Philadelphia, PA, 19095-2816
Phone Number
267-315-5124
Fax Number
267-324-3106
Provider Enumeration Date
05/11/2023
Last Update Date
03/13/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366151854 | 05 | DE | |
| 1386342533 | 05 | PA |
Provider Business Practice Location Address Details
Address
2156 N 30Th St
City
State
Zip
19121-1101
Phone Number
267-315-5124
Fax Number
267-324-3106
Provider Business Mailing Address Details
Address
8480 Limekiln Pike Ph 5
City
State
Zip
19095-2816
Phone Number
267-315-5124
Fax Number
Provider's Taxonomy Details 1
Type
Agencies
Classification
Case Management
Speciality
-
Taxonomy
License No.
()
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
Provider's Taxonomy Details 2
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Mental Illness
Taxonomy
License No.
()
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
Provider's Taxonomy Details 3
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Provider's Taxonomy Details 5
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Provider's Taxonomy Details 6
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Provider's Taxonomy Details 7
Type
Residential Treatment Facilities
Classification
Psychiatric Residential Treatment Facility
Speciality
-
Taxonomy
License No.
()
Definition
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Provider's Taxonomy Details 8
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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