Healthcare Provider Details

I. General information

NPI: 1497506042
Provider Name (Legal Business Name): RHA HEALTH SERVICES NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 03/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 KILCOURSE ST
SOUTH BOUND BROOK NJ
08880-1144
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 732-356-9444
  • Fax:
Mailing address:
  • Phone:
  • 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 State

VIII. Authorized Official

Name: JENNIFER LOZANO
Title or Position: SVP FINANCIAL SERVICES
Credential:
Phone: 770-630-7290