Provider Demographics
NPI:1881058048
Name:OPEN ROADS SERVICES, LLC
Entity type:Organization
Organization Name:OPEN ROADS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:YOHANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:GRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-388-4751
Mailing Address - Street 1:108 CARNEGIE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2927
Mailing Address - Country:US
Mailing Address - Phone:973-388-4751
Mailing Address - Fax:877-744-8986
Practice Address - Street 1:108 CARNEGIE AVE APT 1
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2927
Practice Address - Country:US
Practice Address - Phone:973-388-4751
Practice Address - Fax:877-744-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management