MEDICARE: REBUILD CALIFORNIA ALLIANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1528229879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBUILD CALIFORNIA ALLIANCE

Provider Business Mailing Address
First Line	:	7622 AVALON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-2326
Country	:	US
Telephone Number	:	323-422-1124
Fax Number	:	323-920-7380

Provider Business Practice Location Address
First Line	:	145 W 99TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-4114
Country	:	US
Telephone Number	:	323-422-1124
Fax Number	:	323-531-4063

Authorized Official
Title or Position	:	FOUNDER
Name	:	MR. DEANTWAN FITTS
Credential	:
Telephone Number	:	323-422-1124

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	07/25/2025

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Practice Location Address:

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1437412228 — MRS. VERONICA MARION LEYVA LCSW
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Directions to “REBUILD CALIFORNIA ALLIANCE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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