Healthcare Provider Details

I. General information

NPI: 1508278359
Provider Name (Legal Business Name): THE ROADS FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S LONG BEACH BLVD
COMPTON CA
90221-3423
US

IV. Provider business mailing address

121 S LONG BEACH BLVD
COMPTON CA
90221-3423
US

V. Phone/Fax

Practice location:
  • Phone: 310-627-5850
  • Fax: 310-627-5855
Mailing address:
  • Phone: 310-627-5850
  • Fax: 310-627-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number550002986
License Number StateCA

VIII. Authorized Official

Name: SHAUNT AREVIAN
Title or Position: CEO
Credential: J.D.
Phone: 310-627-5850