Provider Demographics
NPI:1043352305
Name:CONROC, INC. DBA ROCKDALE HOUSES FOR MEN & WOMEN
Entity Type:Organization
Organization Name:CONROC, INC. DBA ROCKDALE HOUSES FOR MEN & WOMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRPERSON, BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-483-0213
Mailing Address - Street 1:1060 SCOTT ST SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-5460
Mailing Address - Country:US
Mailing Address - Phone:770-483-3984
Mailing Address - Fax:
Practice Address - Street 1:1060 SCOTT ST SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-5460
Practice Address - Country:US
Practice Address - Phone:770-483-3984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility