OrganizationActive
Renewal
NPI 1174072003 · Substance Use Disorder Rehabilitation Clinic/Center · Los Angeles, CA
Provider details
- NPI number
- 1174072003
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Elliot Liebhard, Administrator(917) 374-4215
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
672 S La Fayette Park Pl
Los Angeles, CA 91607
Phone: (917) 374-4215
Street-level locationGet directions
Mailing address
4931 Bluebell Ave
Los Angeles, CA 91607
Registry dates
- Enumerated
- 2016-10-04
- Last updated
- 2016-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.