Provider Demographics
NPI:1114684776
Name:ROADS HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ROADS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:RUSHIA
Authorized Official - Middle Name:AYLSE
Authorized Official - Last Name:ROBINSON-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-249-2392
Mailing Address - Street 1:2301 W DUNLAP AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2845
Mailing Address - Country:US
Mailing Address - Phone:424-249-2392
Mailing Address - Fax:
Practice Address - Street 1:2301 W DUNLAP AVE STE 108
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2845
Practice Address - Country:US
Practice Address - Phone:424-249-2392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center