OrganizationActive
Behavioral Health Services
NPI 1104154657 · Substance Abuse Rehabilitation Facility · Gardena, CA
Provider details
- NPI number
- 1104154657
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Teresa Cannon, Cheif Compliance Officer(310) 679-2920
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15519 Crenshaw Blvd
Gardena, CA 90249-4525
Phone: (310) 679-9126
Fax: (310) 679-2800
Street-level locationGet directions
Mailing address
15519 Crenshaw Blvd
Gardena, CA 90249-4525
Registry dates
- Enumerated
- 2009-11-20
- Last updated
- 2009-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.