NPIMap

Organization Active NPI

Adolescent Growth, Inc.

  • Psychiatric Residential Treatment Facility
  • Concord, CA
National Provider Identifier
1710504451
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
ADOLESCENT GROWTH, INC.
Practice address
1170 Vista Ridge CT
Concord, CA 94518-1739
Phone
(888) 948-9998
Fax
(888) 751-6166
NPI assigned
Jun 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

1170 Vista Ridge CT
Concord, CA 94518-1739

Mailing address

60 N Lotus Ave
Pasadena, CA 91107-3811
Phone (626) 768-1742

Other names 1

  • Adolescent Growth, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Adolescent Growth3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

60 N Lotus Ave
Pasadena, CA 91107

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711843200000",
    "number": "1710504451",
    "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": "1170 VISTA RIDGE CT",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181739",
            "telephone_number": "888-948-9998",
            "fax_number": "888-751-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENT GROWTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "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": "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": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Adolescent Growth, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

  • 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.