Healthcare Provider Details

I. General information

NPI: 1396044020
Provider Name (Legal Business Name): RHA HEALTH SERVICES NC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E BLADEN ST
BLADENBORO NC
28320-9347
US

IV. Provider business mailing address

1819 PEACHTREE RD NE STE 450
ATLANTA GA
30309-1848
US

V. Phone/Fax

Practice location:
  • Phone: 828-232-6844
  • Fax:
Mailing address:
  • Phone: 404-364-2900
  • Fax: 404-364-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER D LOZANO
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential: MBA
Phone: 404-364-2900