Growth Extended, Inc.

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

190794AP Issued in CA

Legal business name

GROWTH EXTENDED, INC.

Practice address

15743 Covello St
Lake Balboa, CA 91406-3120

Phone

(888) 948-9998

Fax

(888) 751-6166

NPI assigned

Mar 10, 2017

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

(888) 948-9998

Specialties & licenses 2

Addresses

Tax ID family

Growth Extended2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Growth Extended

  • Psychiatric Residential Treatment Facility
  • Los Angeles, CA
  • NPI 1073854147
  NPD tax ID

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711843200000",
    "number": "1710428628",
    "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": "888-948-9998",
            "fax_number": "888-751-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15743 COVELLO ST",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914063120",
            "telephone_number": "888-948-9998",
            "fax_number": "888-751-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWTH EXTENDED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "888-948-9998"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "CA",
            "license": "190794AP",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190794AP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Letizia Sipos Hendrickson, MS, CCC-SLP
• Karin Howard, M.A., CCC-SLP
• Anik Janjughazyan, LMFT
• Patrick Zen Jen
• Rosielee Artemese Jones, D.C.

• Psychiatric Residential Treatment Facility in Lake Balboa, CA
• Providers in Lake Balboa, CA by specialty
• Psychiatric Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.