Adolescent Growth Virginia, Inc

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

ADOLESCENT GROWTH VIRGINIA, INC

Doing business as

Adolescent Growth Inc

Practice address

1702 Cloncurry Rd
Norfolk, VA 23505-1718

Phone

(888) 948-9998

Fax

(888) 751-6166

NPI assigned

Apr 1, 2024

Last updated

Apr 1, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Lewis

Title

Cfo

Phone

(626) 768-1742

Specialties & licenses 2

Addresses

Other names 1

• Adolescent Growth Inc Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1487405080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N LOTUS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073811",
            "telephone_number": "626-768-1742",
            "fax_number": "888-751-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 CLONCURRY RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235051718",
            "telephone_number": "888-948-9998",
            "fax_number": "888-751-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Waterfall Way",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233229606",
            "country_code": "US",
            "telephone_number": "888-948-9998",
            "fax_number": "888-751-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADOLESCENT GROWTH VIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-30",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "626-768-1742"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adolescent Growth Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric Residential Treatment Facility in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Psychiatric Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.