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Organization
GRO COMMUNITY
Active
Organization
GRO COMMUNITY
Active
Other names
GRO Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AARON MALLORY LCSW (CHIEF EXECUTIVE OFFICER)
(773) 253-8385
Entity
Organization
Contact information
Practice address
259 E 115TH ST, CHICAGO, IL 60628-5014
(618) 203-4368
Mailing address
259 E 115TH ST, CHICAGO, IL 60628-5014
(618) 203-4368
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
IL
Other
Enumeration date
04/06/2018
Last updated
12/12/2023
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