Healthcare Provider Details

I. General information

NPI: 1194588012
Provider Name (Legal Business Name): RHA HEALTH SERVICES NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 CHAPEL PARK LN
GREENSBORO NC
27405-2797
US

IV. Provider business mailing address

1819 PEACHTREE RD NE STE 450
ATLANTA GA
30309-1853
US

V. Phone/Fax

Practice location:
  • Phone: 336-645-4022
  • Fax:
Mailing address:
  • Phone: 800-848-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER D LOZANO
Title or Position: SVP FINANCIAL SERVICES
Credential:
Phone: 404-364-2900