Healthcare Provider Details

I. General information

NPI: 1205933967
Provider Name (Legal Business Name): THE R. A. GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 6TH ST
BURLINGTON NC
27215-5730
US

IV. Provider business mailing address

PO BOX 2828
BURLINGTON NC
27216-2828
US

V. Phone/Fax

Practice location:
  • Phone: 336-227-5854
  • Fax: 336-222-9068
Mailing address:
  • Phone:
  • Fax: 336-222-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberHAL-001-026
License Number StateNC

VIII. Authorized Official

Name: MS. ADA EVELYN LOVE
Title or Position: ADMINISTRATOR
Credential:
Phone: 336-227-5854