=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649944034
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE ROSE GARDEN THERAPY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2021
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 N BELTWAY 8
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77060-4018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-656-1160
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7518 FOX KNOLL LN
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77338-1668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-878-3483
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | DOMINIQUE DENA ROSE
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 281-656-1160
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------