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
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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