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NPI Code Detail

MEDICARE: RHA HEALTH SERVICES TN, LLC

MEDICARE: RHA HEALTH SERVICES TN, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1315P00000XIntellectual Disabilities Intermediate Care FacilityL000000012731TN

General Provider Information

NPI Number : 1497124358
Entity Type Code : Organization
Provider Name (Legal Business Name) : RHA HEALTH SERVICES TN, LLC
Provider Business Mailing Address
First Line : 468 HALLE PARK DR
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-7089
Country : US
Telephone Number : 901-692-5555
Fax Number : 901-692-5561
Provider Business Practice Location Address
First Line : 468 HALLE PARK DR
Second Line :
City : COLLIERVILLE
State : TN
Zip : 38017-7089
Country : US
Telephone Number : 731-855-0537
Fax Number : 731-855-1257
Authorized Official
Title or Position : COO
Name : WAYNE ADDISON
Credential :
Telephone Number : 901-692-5555
Provider Enumeration Date : 09/22/2015
Last Update Date : 09/22/2015

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Directions to “RHA HEALTH SERVICES TN, LLC ” Practice Location

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