Healthcare Provider Details

I. General information

NPI: 1013395698
Provider Name (Legal Business Name): RHA HEALTH SERVICES NC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 WILDCAT RD
DEEP GAP NC
28618-9267
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 828-262-5450
  • Fax:
Mailing address:
  • Phone: 404-364-2900
  • Fax: 404-364-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER LOZANO
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential: MBA, CPC-P
Phone: 404-968-2663