Organization
CONCRETE ROSES CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUKURA BROWN (OWNER)
(980) 263-0991
Entity
Organization
Contact information
Practice address
5960 FAIRVIEW ROAD, 323, CHARLOTTE, NC 28173
(704) 496-2744
Mailing address
2108 DEER MEADOWS DR, WAXHAW, NC 28173-7196
(980) 263-0991
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C008125
LICENSE NUMBER
NC
Enumeration date
10/17/2017
Last updated
10/17/2017
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