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Organization
ADOLESCENT GROWTH VIRGINIA, INC
Active
Organization
ADOLESCENT GROWTH VIRGINIA, INC
Active
Other names
Adolescent Growth Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LEWIS (CFO)
(626) 768-1742
Entity
Organization
Contact information
Practice address
1702 CLONCURRY RD, NORFOLK, VA 23505-1718
(888) 948-9998
(888) 751-6166
Mailing address
60 N LOTUS AVE, PASADENA, CA 91107-3811
(626) 768-1742
(888) 751-6166
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
NULL
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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