Insurance Verification

La Fuente Hollywood Treatment Center accepts many major insurance providers, both in-network and out-of-network. Check your status today by completing the rehab insurance verification form below or calling us at 888.903.9898.

Your Contact Information
Your Name*
First Last
Return Callback Phone Number*
Email*
Who is seeking treatment?*
- Yourself
- A Loved One
How Did You Hear About Us?
Loved Ones Information
Your Information
Loved Ones Name*
First Last
Loved Ones Date Of Birth*
MM slash DD slash YYYY
Your Date Of Birth*
MM slash DD slash YYYY
Additional Information
Insurance Information
Would you like us to verify your or a loved ones insurance benefits?*
- Yes
- No
Policy Holders Name*
First Last
Policy Holders Date Of Birth*
MM slash DD slash YYYY
Policy Holders Address**
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Insurance Company's Name*
Insurance Company's Phone Number*
Member ID*
Group Number*
Subscriber relationship to client*
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Insurance Verification

You Don't Have to Face this Alone.

Inclusive, non-judgmental support for People navigating Chemex, recovery, and mental well-being.

Your Contact Information

Loved Ones Information

Your Information

Insurance Information

Southern California’s Premier LGBTQ Addiction Treatment Program

Southern California’s Premier LGBTQ Addiction Treatment Program

Contact La Fuente Hollywood

State of California Residential and Certification License Number: 190725AP
Expiration date: 9/30/2027

State of California IOP License Number: 190725BP
Expiration date: 5/31/2027

CARF Accreditation
Expiration date: 9/30/2026

About La Fuente Hollywood

LGBTQ Addiction Therapy Programs

LGBTQ Addiction Treatment center

LGBTQ Substance Abuse Treatment Center

Insurance Verification

You Don't Have to Face this Alone.

Inclusive, non-judgmental support for People navigating Chemex, recovery, and mental well-being.

Your Contact Information

Loved Ones Information

Your Information

Insurance Information

Southern California’s Premier LGBTQ Addiction Treatment Program

Southern California’s Premier LGBTQ Addiction Treatment Program

Contact La Fuente Hollywood

State of California Residential and Certification License Number: 190725APExpiration date: 9/30/2027

State of California IOP License Number: 190725BPExpiration date: 5/31/2027

CARF AccreditationExpiration date: 9/30/2026

About La Fuente Hollywood

LGBTQ Addiction Therapy Programs

LGBTQ Addiction Treatment center

LGBTQ Substance Abuse Treatment Center

State of California Residential and Certification License Number: 190725AP
Expiration date: 9/30/2027

State of California IOP License Number: 190725BP
Expiration date: 5/31/2027

CARF Accreditation
Expiration date: 9/30/2026