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General NPI Number Information
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NPI Number | 1194525162
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Entity Type | Organization
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Legal Business Name | GROVE SCHOOL LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 7 DUNWOODY PARK STE 120
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City | ATLANTA
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State | GA
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Zip | 30338-6711
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Country | US
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Telephone | 470-223-8123
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Fax | 470-880-5455
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Provider Business Mailing Address
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Address Line | 1425 MILE POST DR
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City | ATLANTA
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State | GA
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Zip | 30338-4745
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Country | US
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Telephone | 470-223-8123
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Fax | 470-880-5455
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Authorized Official
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Title or Position | OWNER
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Name | WHITNEY BOLLE
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Credential | BCBA
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Telephone | 470-223-8123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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