Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Case Manager/Care Coordinator |
171M00000X | |||
Community Health Worker |
172V00000X | |||
Religious Nonmedical Practitioner |
374K00000X | |||
Social Worker |
104100000X |
| NPI # | 1437004074 |
||||
| LBN Legal business name | IVAN ROBERTS FOUNDATION | ||||
| Authorized official | ANDREA RODNEY - (CEO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/27/2026 | ||||
| Last updated | 02/27/2026 - About 3 months ago | ||||
| Identifiers |
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