# ADOLESCENT GROWTH VIRGINIA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adolescent Growth Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487405080
- **Authorized official:** JOHN LEWIS (CFO)
- **Authorized official phone:** (626) 768-1742

## Contact information

- **Practice address:** 1702 CLONCURRY RD, NORFOLK, VA 23505-1718
- **Practice address phone:** (888) 948-9998
- **Practice address fax:** (888) 751-6166
- **Mailing address:** 60 N LOTUS AVE, PASADENA, CA 91107-3811
- **Mailing address phone:** (626) 768-1742
- **Mailing address fax:** (888) 751-6166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 04/01/2024
- **Last updated:** 04/01/2024