NPI | 1710504451 |
---|---|
Former Legal Business Name | ADOLESCENT GROWTH, INC. |
Entity Type | Organization |
Authorized Contact | JOHN LEWIS CFO 626-768-1742 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
Enumeration Date | 2020-06-29 |
Last Update Date | 2024-03-31 |