Healthcare Provider Details

I. General information

NPI: 1790982841
Provider Name (Legal Business Name): RHA HEALTH SERVICES NC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 09/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 COMMERCE BLVD
STATESVILLE NC
28625-8526
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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

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