Healthcare Provider Details

I. General information

NPI: 1285540435
Provider Name (Legal Business Name): GALAXY BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 E BROADWAY UNIT 302
GLENDALE CA
91205-1085
US

IV. Provider business mailing address

416 E BROADWAY UNIT 302
GLENDALE CA
91205-1085
US

V. Phone/Fax

Practice location:
  • Phone: 310-436-5224
  • Fax:
Mailing address:
  • Phone: 310-436-5224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SARA MOMTAHENI
Title or Position: MANAGING MEMBER
Credential: MA, BCBA
Phone: 310-999-9261