Healthcare Provider Details

I. General information

NPI: 1821123092
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: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 US 21 HWY
HAMPTONVILLE NC
27020-7307
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 704-872-3257
  • Fax: 704-872-3651
Mailing address:
  • Phone: 404-364-2900
  • Fax: 404-364-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

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