Provider Demographics
NPI:1669812392
Name:THE ROADS FOUNDATION, INC
Entity Type:Organization
Organization Name:THE ROADS FOUNDATION, INC
Other - Org Name:ROADS COMMUNITY CLINIC - EAST LONG BEAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:YOSELOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD
Authorized Official - Phone:310-627-5850
Mailing Address - Street 1:121 S LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-3423
Mailing Address - Country:US
Mailing Address - Phone:310-627-5850
Mailing Address - Fax:310-627-5855
Practice Address - Street 1:4800 E LOS COYOTES DIAGONAL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2827
Practice Address - Country:US
Practice Address - Phone:310-627-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty