NPIMap

Organization Active NPI

Authentic Recovery, LLC.

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
National Provider Identifier
1114173036
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190577AP Issued in CA
Legal business name
AUTHENTIC RECOVERY, LLC.
Practice address
2203 Overland Ave
Los Angeles, CA 90064-2025
Phone
(310) 807-5451
NPI assigned
Aug 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Magdalen Gustilo
Title
Avp Payer Relations & Strategy
Phone
(714) 568-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190577AP CA Primary

Addresses

Primary practice location

2203 Overland Ave
Los Angeles, CA 90064-2025

Mailing address

18401 Von Karman Ave Ste 500
Irvine, CA 92612-8531
Phone (714) 828-1800

Other practice location 1

10700 Cushdon Ave
Los Angeles, CA 90064-3219
Phone (310) 388-9612

Other practice location 2

2207 Pelham Ave
Los Angeles, CA 90064-2006
Phone (310) 726-3251

Other names 2

  • Casa Palmera Los Angeles Doing business as
  • Cliffside West LA, Overland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Authentic Recovery Center Cushdon3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1114173036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 OVERLAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642025",
            "telephone_number": "310-807-5451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Cushdon Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900643219",
            "country_code": "US",
            "telephone_number": "310-388-9612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2207 Pelham Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900642006",
            "country_code": "US",
            "telephone_number": "310-726-3251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTIC RECOVERY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "AVP PAYER RELATIONS & STRATEGY",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190577AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Palmera Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Casa Palmera Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cliffside West LA, Overland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.