Healthcare Provider Details

I. General information

NPI: 1427193713
Provider Name (Legal Business Name): RHA HEALTH SERVICES NC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 GATEWOOD AVE
GREENSBORO NC
27405-6816
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 336-273-6105
  • Fax:
Mailing address:
  • Phone: 404-364-2900
  • Fax: 404-364-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberMHL-041-055
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-041-055
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberMHL-041-055
License Number StateNC

VIII. Authorized Official

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