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Organization
LEGACY HEALTH & ACADEMY
Active
Organization
LEGACY HEALTH & ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BALANGA MADISON (ADMINISTRATOR)
(310) 283-8639
Entity
Organization
Contact information
Practice address
1722 W MARTIN LUTHER KING JR BLVD, LOS ANGELES, CA 90062-1502
(310) 283-8639
Mailing address
1722 W MARTIN LUTHER KING JR BLVD, LOS ANGELES, CA 90062-1502
(310) 283-8639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/19/2026
Last updated
08/19/2026
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