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ELMO DETOX
NPI 1912770975
Substance Abuse Rehabilitation Facility in Los Angeles, CA

Active since November 01, 2023CLIA 05D2309414 · Waiver
4646 ST ELMO DR, LOS ANGELES, CA 90019(310) 343-8684 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2023, Nov 2, 2023 (2 updates tracked since 2023).

About Elmo Detox NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELMO DETOX (NPI 1912770975) is a healthcare organization registered as a substance abuse rehabilitation facility in Los Angeles, California and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through August 13, 2026 and lists Nathan Young, Manager, as its authorized official.

NPPES Registry Identity

NPI1912770975
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameELMO DETOX
Location Address4646 ST ELMO DRLos Angeles, CA 90019-5745
Mailing Address1800 Vine St Ste 216Los Angeles, CA 90028-5250
Phone(310) 343-8684
Organization SubpartNo
Authorized OfficialNathan YoungManager · (310) 343-8684
Enumeration DateNovember 1, 2023
Last NPPES UpdateNovember 20, 20232 updates tracked since enumeration
NPPES CertifiedNovember 20, 2023
✔ NPI 1912770975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X
4646 ST ELMO DR, Los Angeles, CA 90019
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2309414

Elmo Detox LLC · Los Angeles, CA
Active · expires Aug 13, 2026
CLIA Number05D2309414
Laboratory TypeRecovery Treatment Ctr
Certificate Effective DateAugust 14, 2024
Certificate Expiration DateAugust 13, 2026
Laboratory DirectorBryan Yang
Laboratory Phone(310) 343-8684
Laboratory LocationElmo Detox LLC4646 St Elmo Bldg E, Los Angeles, CA 90014
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elmo Detox's NPI number?

The NPI number for Elmo Detox is 1912770975. It was assigned to this organization in the NPPES registry on November 1, 2023.

Where is Elmo Detox located?

Elmo Detox is located at 4646 St Elmo Dr, Los Angeles, CA 90019. The listed phone number is (310) 343-8684.

What is Elmo Detox's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Elmo Detox hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2309414) is associated with this NPI, valid through August 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Elmo Detox was last updated on November 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.