Revive Detox
NPI 1639561566 · Substance Abuse Rehabilitation Facility · Los Angeles, CA
Revive Detox is a Substance Abuse Rehabilitation Facility organization in Los Angeles, CA (NPI 1639561566).
Provider details
- NPI number
- 1639561566
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Matthew Conley, Program Director(818) 462-3824
- License
- 190836AP (CA)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
Mailing address
Registry dates
- Enumerated
- 2015-03-02
- Last updated
- 2015-03-02
Frequently asked questions
- What is Revive Detox's NPI number?
- Revive Detox's National Provider Identifier (NPI) is 1639561566, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Detox?
- Revive Detox is classified in the NPPES registry as Substance Abuse Rehabilitation Facility (Residential Treatment Facilities).
- Where is Revive Detox located?
- Revive Detox's practice location on file with NPPES is 360 N Vista St, Los Angeles, CA 90036-5739.
- What is Revive Detox's phone number?
- The practice phone number listed in the NPPES registry for Revive Detox is (818) 462-3824.
- Who is the authorized official for Revive Detox?
- The authorized official listed on Revive Detox's NPPES record is Matthew Conley, Program Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Detox's NPI active?
- Yes — Revive Detox's NPI (1639561566) is active in the NPPES registry as of the last update on 2015-03-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.