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Organization
TAILORED ROOTS BEHAVIORAL HEALTH, LLC
Active
Organization
TAILORED ROOTS BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUANDA S GORDON PMHNP-BC (OWNER/MANAGING MEMBER)
(470) 583-2403
Entity
Organization
Contact information
Practice address
825 BELMAR PASS, FAIRBURN, GA 30213-4482
(470) 583-2403
Mailing address
825 BELMAR PASS, FAIRBURN, GA 30213-4482
(470) 583-2403
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
Other
Enumeration date
10/16/2026
Last updated
10/16/2026
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