Healthcare Provider Details

I. General information

NPI: 1285599746
Provider Name (Legal Business Name): AVENUES RECOVERY EXTENDED CARE AT NORFOLK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6403 GRANBY ST
NORFOLK VA
23505-4447
US

IV. Provider business mailing address

211 BOULEVARD OF THE AMERICAS SUITE 503
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 732-967-2635
  • Fax:
Mailing address:
  • Phone: 732-967-2635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUDI ALTER
Title or Position: CEO
Credential:
Phone: 732-967-2635