Legacy Horizon Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LEGACY HORIZON INC.

Practice address

13942 Dominican Ave
Moreno Valley, CA 92555-2566

Phone

(951) 214-2581

NPI assigned

Aug 7, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Mulyatno

Title

Cfo

Phone

(951) 214-2581

Specialties & licenses 1

Addresses

Other names 1

• Legacy Horizon Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1205711355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13942 DOMINICAN AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552566",
            "telephone_number": "951-214-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13942 DOMINICAN AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552566",
            "telephone_number": "951-214-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HORIZON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "MULYATNO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "951-214-2581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Horizon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Lee, DO
• Peter Jaikon Lee, MD, MPH
• Sunny Lee
• Thomas Lee, PHARMD
• Toni Y Lee, RPH
• Cheri Lynn Legerme, CBD/CPD, CHW
• Angel Kay Lemaster
• Justin James Lemoine, DPT
• Lemonade Counseling Services
• Danisa Lemus

• Skilled Nursing Facility in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.