Provider Demographics
NPI:1639761638
Name:ROAN SOLUTIONS LLC
Entity Type:Organization
Organization Name:ROAN SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKOCZY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-522-1719
Mailing Address - Street 1:734 POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8023
Mailing Address - Country:US
Mailing Address - Phone:815-522-1719
Mailing Address - Fax:
Practice Address - Street 1:55 E CRYSTAL LAKE AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6151
Practice Address - Country:US
Practice Address - Phone:815-522-1719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health