Organization
ADVANCED GROWTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIEU MA (DIRECTOR OF OPERATION)
(888) 549-8884
Entity
Organization
Contact information
Practice address
19W706 13TH PL, LOMBARD, IL 60148-4505
(888) 948-9998
(888) 776-8838
Mailing address
PO BOX 910913, LOS ANGELES, CA 90091-0913
(888) 549-8884
(888) 751-6166
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
533073-01
IL
324500000X
Substance Abuse Rehabilitation Facility
533073-01
IL
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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