ADVANCED DETOX AND REHAB CENTER — NPI 1912726233 (Licensed & Credentialed Substance Abuse Rehabilitation Facility in NORTHRIDGE, CA)

CMS-1500 Box 24J / 33a • NPI

1912726233

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

324500000X

Licensed & Credentialed Substance Abuse Rehabilitation Facility

Box 32 Service Location & ZIP+4

19122 HALSTED ST, NORTHRIDGE, CA, 91324-1716

✓ 9-Digit EDI 837 ZIP+4 (91324-1716)

Practice Phone & Referral Fax

(350) 500-0005

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1912726233 (ADVANCED DETOX AND REHAB CENTER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1912726233` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED DETOX AND REHAB CENTER
Plain-English Specialty	Licensed & Credentialed Substance Abuse Rehabilitation Facility NUCC Code: `324500000X` (Substance Abuse Rehabilitation Facility)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	19122 HALSTED ST, NORTHRIDGE, CA, 91324-1716
Practice Telephone / Fax	Tel: (350) 500-0005
Administrative Mailing Address	19122 HALSTED ST, NORTHRIDGE, CA, 91324-1716
Enumeration & Last Sync	Enumerated: 2024-10-03 \| CMS Record Updated: 2024-10-03
Authorized Official	NAREK KHALATYAN (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

19122 HALSTED ST, NORTHRIDGE, CA, 91324-1716

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Plain-English Taxonomy & CMS Crosswalk (324500000X)

What Does Taxonomy Code 324500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 324500000X translates to:
"Licensed & Credentialed Substance Abuse Rehabilitation Facility"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Substance Abuse Rehabilitation Facility for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED DETOX AND REHAB CENTER)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`324500000X` — Substance Abuse Rehabilitation Facility Plain English: Licensed & Credentialed Substance Abuse Rehabilitation Facility	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED DETOX AND REHAB CENTER (NPI #1912726233)