Organization
LEGACY FOUNDATION CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY JOHNSON (PROGRAM ADMINISTRATOR)
(951) 900-3750
Entity
Organization
Contact information
Practice address
11840 MAGNOLIA AVE STE G, RIVERSIDE, CA 92503-4900
(951) 900-3812
Mailing address
11840 MAGNOLIA AVE STE G, RIVERSIDE, CA 92503-4900
(951) 900-3812
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
05/21/2025
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