Organization
RIVENDELL COUNSELORS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA THOMAS (OWNER)
(678) 687-1495
Entity
Organization
Contact information
Practice address
3617 BRASELTON HWY STE 104, DACULA, GA 30019-4667
(678) 687-1495
Mailing address
3617 BRASELTON HWY STE 104, DACULA, GA 30019-4667
(678) 687-1495
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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