Organization
HOUSE OF CONCRETE ROSES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANEQUA DORSEY LMSW (OWNER)
(404) 697-7360
Entity
Organization
Contact information
Practice address
1133 HUFF RD NW APT 766, ATLANTA, GA 30318-4327
(404) 697-7360
Mailing address
1133 HUFF RD NW APT 766, ATLANTA, GA 30318-4327
(404) 697-7360
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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