Legacy Healing Center Los Angeles LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LEGACY HEALING CENTER LOS ANGELES LLC

Practice address

1924 Wattles Dr
Los Angeles, CA 90046-2264

Phone

(561) 308-0865

NPI assigned

Oct 8, 2024

Last updated

Jan 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erin Kennedy

Title

Cro

Phone

(954) 665-0823

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1427877216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 185",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314000",
            "telephone_number": "954-665-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 WATTLES DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900462264",
            "telephone_number": "561-308-0865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18641 Cassandra St",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913564509",
            "country_code": "US",
            "telephone_number": "561-308-0865",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5201 Veloz Ave",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913564125",
            "country_code": "US",
            "telephone_number": "561-308-0865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY HEALING CENTER LOS ANGELES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "954-665-0823"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tai Logan Legagnoux, AMFT
• Legal Psychological Evaluations, Inc.
• John Brian Legall, M.D.

• Substance Abuse Rehabilitation Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.