Organization
GROLL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA GROLL (PRESIDENT)
(708) 925-3540
Entity
Organization
Contact information
Practice address
1580 N NORTHWEST HWY STE 305C, PARK RIDGE, IL 60068-1469
(708) 925-3540
(708) 925-3540
Mailing address
4707 N OKETO AVE, HARWOOD HEIGHTS, IL 60706-4612
(708) 925-3540
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/19/2019
Last updated
06/07/2019
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