Organization
LEGACY HORIZON INC.
Active
Other names
Legacy Horizon
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MULYATNO (CFO)
(951) 214-2581
Entity
Organization
Contact information
Practice address
13942 DOMINICAN AVE, MORENO VALLEY, CA 92555-2566
(951) 214-2581
Mailing address
13942 DOMINICAN AVE, MORENO VALLEY, CA 92555-2566
(951) 214-2581
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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