Authentic Recovery, LLC.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

AUTHENTIC RECOVERY, LLC.

Practice address

2207 Pelham Ave
Los Angeles, CA 90064-2006

Phone

(310) 726-3251

NPI assigned

Jan 14, 2022

Organization subpart

No

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

Authorized official

Name

Magdalen Gustilo

Title

Director of Payer Relations

Phone

(714) 568-7667

Specialties & licenses 1

Addresses

Other names 2

• Authentic Recovery Center, Pelham Doing business as
• Casa Palmera Los Angeles Doing business as

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.

• Authentic Recovery, LLC.

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1114173036
  NPD tax ID
• Authentic Recovery, LLC.

  • Substance Abuse Rehabilitation Facility
  • Los Angeles, CA
  • NPI 1508517269
  NPD tax ID

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1144971813",
    "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": "2207 PELHAM AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642006",
            "telephone_number": "310-726-3251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2203 Overland Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900642025",
            "country_code": "US",
            "telephone_number": "310-807-5451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTIC RECOVERY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Authentic Recovery Center, Pelham",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Casa Palmera Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan M Austria, COTA/L
• Kristine Joyce Austria, CRNA
• Nina Payuyo Autajay
• Authentic Psychological Services Inc
• Authentic Recovery, LLC.
• Authentic Recovery, LLC.
• Autism Asperger Support Center
• Autism Believe Accept Therapy Services
• Autism Spectrum Support Center, LLC
• Autonomous User Rehabilitation Agent, LLC

• Substance Abuse Rehabilitation Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.