Provider Demographics
NPI:1437840964
Name:AG BEHAVIORAL HEALTH AND CONSULTING LLC
Entity Type:Organization
Organization Name:AG BEHAVIORAL HEALTH AND CONSULTING LLC
Other - Org Name:SIMPLY BEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-688-3516
Mailing Address - Street 1:175 E HAWTHORN PKWY
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1463
Mailing Address - Country:US
Mailing Address - Phone:224-424-0432
Mailing Address - Fax:
Practice Address - Street 1:175 E HAWTHORN PKWY STE 175
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1463
Practice Address - Country:US
Practice Address - Phone:224-424-0432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty