Provider Demographics
NPI:1194958983
Name:RODGERS' INITIATIVE FOR CHILDREN'S HEALTH
Entity type:Organization
Organization Name:RODGERS' INITIATIVE FOR CHILDREN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-900-5876
Mailing Address - Street 1:15255 KESSLER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3317
Mailing Address - Country:US
Mailing Address - Phone:704-674-6986
Mailing Address - Fax:704-900-5876
Practice Address - Street 1:15255 KESSLER DR
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3317
Practice Address - Country:US
Practice Address - Phone:704-674-6986
Practice Address - Fax:704-900-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health